Özet:

During pregnancy, while the blood volume, heart output, heart rate increase, the systemic vascular resistance decreases. These changes can be tolerated by pregnant healthy women but they can be an overload on the heart with pregnant women who have heart diseases. For this reason the peripartum morbidity and mortality increase. The selection of anesthesia in these patients vary according to the type of heart disease, drugs used, and to the urgency of the surgery. Our case was a 32-year-old who had four gravity, two parity and two abortions. Caesarean section was planned for the patient at 39 weeks of gestation In the preoperative examination we learned that she had underwent a percutaneous mitral balloon valvuloplasty five years ago. In echocardiography the mitral valve area was 1 square centimeter, 30 aortic insufficiency was detected and pulmonary artery pressure was 35 mm Hg. The spinal-epidural anesthesia was performed through the L4-L5 intervertebral space with the patient in the sitting position. Perioperative anesthesia and analgesia were provided by epidural catheter. As a result we believe that the low-dose combined spinal-epidural anaesthesia will be more stable on the hemodynamics in the implementation of cesarean section in pregnant women with heart disease and we believe that providing postoperative analgesia via an epidural catheter may prevent the adverse effects such as tachycardia, hypertension and agitation.

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