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 analgesia and interventional assisted delivery is discussed with reference to this patient group, and other aspects of peripartum management of concern to the anaesthetist.