In conclusion, bacterial endocarditis is a rare but very serious pregnancy complication that may lead to maternal death. The predisposing factors for the development of endocarditis appeared to have changed during the past two decades. Intravenous drug abuse, rather than rheumatic and congenital heart defects, is emerging as a major cause of endocarditis. Importantly, diagnostic evaluation and therapy during pregnancy are essentially identical to those for nonpregnant patients.