Key result
Volume resuscitation and norepinephrine resolve a hypoxic Tet spell following cesarean delivery in uncorrected ToF.
Why the study?
Hemodynamic changes during pregnancy in uncorrected Tetralogy of Fallot can cause serious, life-threatening complications for both mother and baby.
Case Report (n=1)
No
Highlights the importance of multidisciplinary care and invasive monitoring in managing pregnant patients with uncorrected Tetralogy of Fallot undergoing cesarean delivery.
Volume resuscitation with norepinephrine may stabilize post-cesarean Tet spells in uncorrected TOF; single case leaves optimal management open.
Tetralogy of Fallot (TOF) is the most common, cyanotic congenital heart disease. The hemodynamic changes during pregnancy, with uncorrected TOF, result in serious, life-threatening complications for both patient and baby. The authors report on the successful anesthetic management of a 26-year-old parturient women. The patient was at a gestational age of 33 weeks, with uncorrected TOF. After undergoing a cesarean delivery, she developed intraoperative hypoxia after delivery. We postulated that the patient developed hypoxic Tet spells from hypovolemia, resulting from postpartum bleeding as well as a decrease in her systemic vascular resistance from oxytocin. A multidisciplinary team approach and invasive intraoperative monitoring together with meticulous anesthetic management, were essential for this patient.
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Lertkovit et al. (2020) conducted a case report in Uncorrected Tetralogy of Fallot in pregnancy (n=1). General anesthesia and volume resuscitation with vasopressors was evaluated on Recovery from hypoxic Tet spell and successful delivery. A 26-year-old pregnant woman with uncorrected Tetralogy of Fallot who developed a hypoxic Tet spell after cesarean delivery was successfully managed with volume resuscitation and norepinephrine.
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