Obstetric epidural analgesia in aortic stenosis: a low-dose technique for labour and instrumental delivery

Five patients with valvular or fixed subvalvular aortic stenosis presented to a high-risk obstetric anaesthetic clinic over a 3-year period. All five were assessed during pregnancy and admitted at full term. A low-dose lumbar epidural analgesia regimen was used during labour and delivery. The use of pre-assessment and planned admission, invasive monitoring, epidural analge sia and interventional assisted delivery is discussed with reference to thi s patient group, and other aspects of peripartum management of concern to t he anaesthetist. (C) 2000 Harcourt Publishers Ltd.