[Management of cardiac high risk pregnancy. Caesarean section in a primagravida with cyanotic cardiac defect]. / Management bei kardialer Hochrisikoschwangerschaft. Sectio bei einer I. Gravida mit zyanotischem Vitium.

A 37-year-old gravida I with cyanotic heart disease presented for caesarean section in the 31st week of gestation. Caesarean section was performed uneventfully with the patient under epidural anaesthesia accompanied by invasive monitoring. Postoperative echocardiography showed no change in the shunt fraction, volumes or the ventricular function. Every patient with complex comorbidities has to be managed according to individual prerequisites and the experiences and preferences of the team. For such high risk pregnancies regional anaesthesia seems to be a possible option although no clear evidence can be found in the literature.