SEVERE MITRAL-STENOSIS IN A PARTURIENT WITH CONGESTIVE CARDIAC-FAILURE AND HYPOGLYCEMIA

We report a case of maternal mortality in a 34-year-old multipara who presented at the 35th week of gestation with severe hypoglycaemia. She had no history of diabetes mellitus. This episode was a prelude to ca tastrophic and refractory congestive cardiac failure due to previously undiagnosed severe mitral stenosis. The rapid cardiovascular deterior ation initially appeared to be consistent with amniotic fluid embolism . She also developed deranged liver function with disseminated intrava scular coagulation, which mimicked acute fatty liver of pregnancy. The problems of diagnosis and management are discussed. Unfortunately the patient died before mitral valvular commissurotomy could be effected.