TY - JOUR T1 - Management of a parturient with uncorrected tetralogy of Fallot in shock: an anesthetic challenge JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-231517 VL - 12 IS - 12 SP - e231517 AU - Snigdha Bellapukonda AU - Bhim Raju Roncall AU - Manisha Mund Y1 - 2019/12/01 UR - http://casereports.bmj.com/content/12/12/e231517.abstract N2 - 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. ER -