Low dose Spinal Anaesthesia for Cesarean Section in Gravida with Rheumatic Heart Disease

Abstract

Cardiac disease in pregnancy remains an important etiology of maternal and fetal morbidity and mortality.1 Mitral stenosis is the most commonly acquired valve lesion encountered in pregnant women and is almost invariably caused by Rheumatic heart disease (RHD).1 Pregnancy and peripartum period represent a physiologic burden that may worsen symptoms in even moderate degrees of cardiac disease.1 Consequently, many women are first diagnosed with the cardiac disease during pregnancy.1 In this case report, we describe the peripartum management of a 38 year old woman with congestive heart failure functional class II, severe mitral stenosis (MS), moderate mitral regurgitation (MR), and moderate tricuspid regurgitation because of RHD. She successfully underwent cesarean section with low-dose spinal anaesthesia using 7 mg hyperbaric bupivacaine intrathecally. This report highlights that low-dose spinal anaesthesia remains a good option in anaesthesia management for cesarean section in gravida with RHD, especially with severe MS.

Keywords

• rheumatic heart disease
• rhd
• severe mitral stenosis
• low dose spinal anaesthesia
• cesarean section.