Combined spinal epidural anaesthesia in a primigravida with valvular heart disease

PurposeThis is the first report describing combined spinal epidural anaesthesia for labour and unexpected Caesarean section in a patient with mitral and aortic stenosis and insufficiency.Clinical featuresThe patient was a 30-yr-old GIPO with a history of rheumatic fever. She had moderate stenosis and insufficiency of the mitral and aortic valves. Combined spinal and epidural anaesthesia was used throughout labour and subsequent Caesarean section. The patient remained haemodynamically stable throughout the procedure.ConclusionCarefully planned regional anaesthesia was safely used for labour and operative delivery in this parturient with mitral and aortic valvular disease.