Introduction

Rheumatic heart disease is still a major health problem associated with pregnancy in india, despite its declining trend. Rheumatic mitral stenosis forms 88% of heart diseases complicating pregnancy in tertiary referral centre in India^[1]. The mortality and morbidity are considerably reduced^[2] by better perinatal care, where anaesthesiologist plays a major role in the multidisciplinary approach.

Case Presentation

Patient Smt. Heena having 9 months pregnancy with RHD with severe MS with mild MR / moderate AR/ mild TR with ejection fraction 60%was diagnosed at 8 month during this (second) pregnancy posted for FTLSCS.

She was operated for FTLSCS under spinal anaesthesia 3.5 years back. Intraoperatively, she developed pulmonary edema and managed for that and was admitted in ICU for treatment but relative took it to somewhat like respiratory complication.

1. Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, et al. Cardiac disease in pregnancy. IntJ Gynaecol Obstet. 2003;82:153-9.
2. Malhotra M, Sharma JB, Tripathii R, Arora P, Arora R. Maternal and fetal outcome in valvular heart disease. Int J gynaecol Obstet. 2004;84:11-6.
3. Kuczkowski KM, vanZundert A. Anaesthesia for pregnant women with valvular heart disease:the state-of-art. J Anesth.2007;21:252-257.
4. Weiner MM, Vahl TP, Kahn RA,. Case scenario: Cesarean section complicated by rheumatic mitral stenosis. Anesthesiology. 2011;114:949-957.

Dr Sonali Dhawan

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