Pregnancy in women with Noonan syndrome: report of two cases.

Background: Noonan syndrome is similar phenotypically to Turner syndrome, accounting for one in 1000-2500 live births. Two thirds of patients have cardiac anomalies, half with pulmonary stenosis. Two cases of Noonan syndrome in pregnancy are presented, each woman with a different cardiac anomaly.

Litigation in Canada against anesthesiologists practicing regional anesthesia. A review of closed claims.

Purpose: To review the pattern of malpractice litigation related to regional anesthesia in Canada.

Source: The Canadian Medical Protective Association (CMPA) provided with information about all anesthesia claims that closed in the years 1990-1997.

Principal Findings: In the period 1990-97 there were 7,909 closed legal actions involving all CMPA members (56,000).

Combined spinal epidural anaesthesia in a primigravida with valvular heart disease.

Purpose: This is the first report describing combined spinal epidural anaesthesia for labour and unexpected Caesarean section in a patient with mitral and aortic stenosis and insufficiency.

Clinical Features: The patient was a 30-yr-old GIPO with a history of rheumatic fever. She had moderate stenosis and insufficiency of the mitral and aortic valves.