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CASE REPORT
Year : 2017  |  Volume : 37  |  Issue : 1  |  Page : 26-28

Vaginal delivery in a case of mitral stenosis: Sevoflurane to the rescue


1 Department of Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
2 Department of Anaesthesiology and Critical Care, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Correspondence Address:
Vishal Krishna Pai
Department of Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1011-4564.200739

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Rheumatic heart disease is the most common cardiac disease associated with pregnancy in developing countries. In India, rheumatic mitral stenosis (MS) comprises 88% of heart diseases complicating pregnancy. Despite advances and improved anesthetic techniques, the management of parturients with cardiac valvular pathology can be challenging. Therefore, the anesthesiologist has to be vigilant and meticulous in planning the technique of anesthesia to aid in safe confinement. In this article, we present the anesthetic management of a parturient who presented to our hospital with a medical record of moderate MS, in active labor. We combined a technique most feasible at that moment, with tactful and detailed knowledge of the pathophysiology to guide our anesthetic management and facilitate a normal vaginal delivery. We have tried to highlight how clinically individualized and personalized care with sound pathophysiological knowledge of the patient's cardiac condition can achieve optimal outcomes, especially when conventional modes and techniques are not feasible.


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