Key result
Titrated epidural analgesia with an assisted second stage of labor resulted in a smooth, hemodynamically stable vaginal delivery in a patient with severe mitral and aortic valve stenosis.
Case Report (n=1)
No
Epidural anesthesia can be successfully and safely used for labor and delivery in patients with combined aortic and mitral stenosis.
May support epidural feasibility in combined valvular stenosis; single case leaves open need for prospective confirmation before practice change.
Maternal heart disease complicates 0.2-3% of pregnancies. The optimal management of the pregnant patient with cardiac disease depends on the co-operative efforts of the obstetrician, the cardiologist and the anesthesiologist involved in peripartum care. A comprehensive understanding of physiology of pregnancy and pathophysiology of underlying cardiac disease is of primary importance in provision of obstetric analgesia or anesthesia for these high-risk groups of patients. We report a successful and uncomplicated use of epidural anesthesia for labor and delivery in patient with combined aortic and mitral stenosis.
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Kela et al. (2015) conducted a case report in Combined severe mitral and aortic valve stenosis in pregnancy (n=1). Epidural analgesia was evaluated on Successful vaginal delivery and hemodynamic stability. Titrated epidural analgesia with an assisted second stage of labor resulted in a smooth, hemodynamically stable vaginal delivery in a patient with severe mitral and aortic valve stenosis.
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