Undiagnosed Mitral Stenosis in Labour

You are asked to provide analgesia for a 26-year-old woman who presented in labour to your regional hospital on a weekday. She has a three month history of shortness of breath on minimal exertion. She has not presented for any antenatal care during the pregnancy and the shortness of breath has not been investigated. Otherwise she has had an uneventful pregnancy. Her observations are: Pulse 110/min, BP 110/80 mmHg, Respiratory rate 24/min, SpO2 95%, Height 170 cm, Weight 75 kg