Publication:

Vaginal delivery in a patient with asymptomatic severe aortic stenosis: a case report

Heart disease complicates about 1-4% of all pregnancies of which valvular heart disease is the commonest cause. In developing countries, congenital heart diseases are commonly first detected during pregnancy. Most women do well during pregnancy but severe mitral stenosis or severe aortic stenosis are high-risk conditions that can cause significant morbidity and mortality. Unlike asymptomatic severe mitral stenosis, asymptomatic severe aortic stenosis is mWHO category 3. There is no consensus on the mode of delivery in patients with asymptomatic severe aortic stenosis. Here we describe a case of successful vaginal delivery in a woman with severe aortic stenosis. As the patient was asymptomatic and ejection fraction was preserved, a joint decision for vaginal delivery was taken along with the cardiology team. The patient was induced and delivered with operative vaginal delivery. This case shows that vaginal delivery could be a viable option in patients with asymptomatic severe aortic stenosis given continuous haemodynamic monitoring can be provided.