This study was conducted to determine the most rational and safe option for regional anaesthesia during abdominal delivery in patients with "moderately expressed" mitral stenosis with an area of 2.9-2.0 cm2 and reduced coronary reserves. The study included 51 women with these conditions. Depending on the anaesthesia option, all patients were divided into three equal groups. Patients in the first group underwent spinal anaesthesia, those in the second group underwent epidural anaesthesia, and patients in the third group were operated on under balanced epidural anaesthesia with reduced concentrations of local anaesthetic in combination with fentanyl and preventive analgesia. Central and peripheral hemodynamics and the functional state of the sympathoadrenal and hypothalamohypophyseal systems were studied during the stages of anaesthesia and surgery. The most rational and safe method of analgesia in patients with MS and reduced coronary reserves is epidural anaesthesia with reduced concentrations of bupivacaine hydrochloride in combination with fentanyl and preventive analgesia.