Cesarean section under epidural ropivacaine 0.75% in a parturient with severe pulmonary hypertension

Pregnancy and delivery are a potentially lethal combination in a patient wi th primary pulmonary hypertension. There are controversies regarding mode o f delivery. Cesarean section is considered to be associated with extensive perioperative risks. We report on a parturient with severe pulmonary hypert ension who underwent a succesful semiemergent cesarean section on vital ind ication. Vaginal delivery was excluded since her cervix was too immature fo r succesful induction. This is the first reported case of its kind to recei ve an epidural anesthesia with ropivacaine with its potential advantage of a low cardiac toxicity. The epidural was slowly and carefully titrated to g ive a stable anesthesia with good quality.