A history of previous cardiac disease increases the maternal mortality risk by as much as 100%. There is no consensus on the absolute contraindications to vaginal delivery in valvular heart disease, but central regional anesthesia is traditionally considered contraindicated in patients with severe aortic stenosis. A 29-year-old primigravid woman with severe aortic stenosis was admitted to the obstetrics department for programmed labor induction. With epidural anesthesia and mini-invasive hemodynamic monitoring labor and operative vaginal delivery were well tolerated, and hemodynamic stability was always maintained. Epidural analgesia and oxytocin induction are possible for the labor management of parturients with severe aortic stenosis given that continuous non-invasive followed by invasive hemodynamic monitoring can be provided and given the absence of any obstetric or cardiologic contraindications and the strong will of the patient.

中文翻译：

---

重度主动脉瓣狭窄患者硬膜外镇痛阴道分娩一例报告

既往心脏病史会使孕产妇死亡风险增加高达 100%。对于瓣膜性心脏病阴道分娩的绝对禁忌症尚未达成共识，但传统上认为中央区域麻醉对于严重主动脉瓣狭窄患者是禁忌的。一名29岁初产妇，患有严重主动脉瓣狭窄，入院产科进行程序性引产。在硬膜外麻醉和微创血流动力学监测下，分娩和手术阴道分娩的耐受性良好，血流动力学始终保持稳定。硬膜外镇痛和催产素诱导对于严重主动脉瓣狭窄产妇的临产处理是可能的，因为可以提供连续的无创性随后有创的血流动力学监测，并且没有任何产科或心脏病禁忌症以及患者的强烈意愿。