Combined spinal epidural anesthesia and non-invasive positive pressure ventilation for emergency cesarean section in a parturient with acute pulmonary edema due to pre-existing multivalvular cardiac disease

Abstract

Acute pulmonary edema in pregnant women with pre-existing cardiac disease is an uncommon problem, which may lead to significant maternal morbidity and mortality. It may occur due to superimposed characteristic features of the physiological changes related to pregnancy. The management is difficult, because there is no controlled trials or guidelines. The authors present their management of combined spinal epidural anesthesia with non-invasive ventilation in a parturient with acute pulmonary edema, due to pre-existing multivalvular heart disease and pulmonary hypertension, who underwent an emergency cesarean section because of preterm labour and fetal distress.