1Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
2Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
The physiological adaptations of the cardiovascular system during pregnancy can significantly exacerbate pre-existing valvular heart disease. This pathological state elevates the risk of adverse outcomes for both the mother and fetus, necessitating meticulous peripartum management, with the choice of anesthetic technique being a critical component. This report aims to delineate the anesthetic strategies employed in two cases of cesarean delivery complicated by valvular heart disease. Case one involves a 28-year-old gravida with Rheumatic Heart Disease presenting as multivalvular involvement, specifically severe tricuspid regurgitation, moderate mitral regurgitation, mild aortic regurgitation, and moderate pulmonary regurgitation. The second case details a 24-year-old gravida with severe, high-flow, high-gradient aortic stenosis, a condition consistent with a modified World Health Organization (mWHO) class IV risk categorization. Both patients underwent pregnancy termination via cesarean section using regional epidural anesthesia with titrated administration of 1.5% lidocaine and invasive hemodynamic monitoring using arterial blood pressure monitoring. During the surgical procedure, the hemodynamic conditions of both patients were relatively stable. Patients were treated in the intensive care unit for two days postoperatively before being transferred to the ward and discharged in stable condition. This case report demonstrates that a multidisciplinary approach combined with titrated epidural anesthesia and strict hemodynamic monitoring can be a safe strategy in anesthesia management for pregnancy with valvular heart disease.
Keywords: pregnancy; valvular heart disease; stenosis; regurgitation; regional anesthesia.
How to cite this article: Gunawan W., Fitriati M. Anesthesia Management in Pregnancy with Valvular Heart Disease: Increasingly Varied Current Challenges. Int J Drug Deliv Technol. 2026;16(16s): 267-272. DOI: 10.25258/ijddt.16.16s.28
Source of support: Nil.
Conflict of interest: None