title: Combined spinal epidural anaesthesia in a primigravida with valvular heart disease.
abstract: OBJECTIVE
  This 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.
  
  
  METHODS
  The 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 epidural anaesthesia was used throughout labour and subsequent Caesarean section. The patient remained haemodynamically stable throughout the procedure.
  
  
  CONCLUSIONS
  Carefully planned regional anaesthesia was safely used for labour and operative delivery in this parturient with mitral and aortic valvular disease.
authors.affiliation: Department of Anaesthesia, McMaster University, Ontario, Canada.
authors.forename: T
authors.initials: T
authors.lastname: VanHelder
authors.forename: K G
authors.initials: KG
authors.lastname: Smedstad
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D005260:Female; D006349:Heart Valve Diseases / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*