Tet spells in a parturient woman with uncorrected tetralogy of fallot undergoing cesarean delivery

• Main Authors: Saranya Lertkovit, Patchareya Nivatpumin
• Other Authors: Siriraj Hospital
• Format: Article
• Published: 2022
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/77732
• Institution: Mahidol University

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.