RT Journal Article
SR Electronic
T1 Management of a parturient with uncorrected tetralogy of Fallot in shock: an anesthetic challenge
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e231517
DO 10.1136/bcr-2019-231517
VO 12
IS 12
A1 Snigdha Bellapukonda
A1 Bhim Raju Roncall
A1 Manisha Mund
YR 2019
UL http://casereports.bmj.com/content/12/12/e231517.abstract
AB Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. The survival of patients with uncorrected TOF till the fourth decade of life is rare (around 3%). Pregnancy in a patient with uncorrected TOF requires a multidisciplinary approach. A confluence of pregnancy, uncorrected TOF and shock is infrequent. The state of hypovolaemia and a decrease in systemic vascular resistance due to anaesthetic agents increase the right to left shunt. The decrease in pulmonary blood flow provokes a ‘hypercyanotic spell’. We report the successful management of 30-year-old pregnant (G3P2A2L0) with uncorrected TOF, presenting to the emergency department with incomplete abortion in shock.