Anaesthesia for the Pregnant Patient with Acquired Valvular Heart Disease

Management in pregnancy should be multi-disciplinary. Obstetric, cardiology and anaesthetic opinions should all be sought. The following need to be addressed: accurate diagnosis as to which valves are involved, assessment of the severity of the lesion, degree of impairment resulting from the lesion and evaluation of concomitant therapy. In addition, as well as optimising management during pregnancy and labour, it is important that care be carried on into the puerperium. The majority of reported deaths in cases of valvular heart disease in pregnancy occur in the post-partum period. Intensive monitoring should be continued for at least 72 hours after delivery, preferably in a high care or intensive care environment.