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Saudi J Anaesth. 2019 Jul-Sep;13(3):237-239. doi: 10.4103/sja.SJA_781_18.

Anesthetic challenges in a pregnant patient with post mitral valve replacement, complete heart block, and coagulopathy coming for emergency cesarean section: A case report.

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Department of Anesthesiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.


A 24-year-old primigravida with a history of rheumatic heart disease and prosthetic mitral valve on oral anticoagulation who was lost follow-up during the third trimester presented with premature rupture of membranes. On evaluation, she had new-onset complete heart block. She was temporarily paced but developed cardiac failure. Anesthetic challenges and management of this parturient with post mitral valve replacement, complete heart block, and warfarin-induced coagulopathy for emergency cesarean delivery are discussed in this case report. Ours is the first case report of a pregnant patient with new onset of complete heart block during pregnancy several years after mitral valve replacement.


Cesarean delivery; coagulopathy; complete heart block; parturient; prosthetic mitral valve; warfarin

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