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 …