Anaesthesia for caesarean section in a patient with uncorrected Tetralogy of Fallot complicated by eclampsia

Congenital heart disease (CHD) occurs in approximately 1% of the global population. Tetralogy of Fallot (TOF) is the most common cyanotic lesion.1 Survival until adulthood is rare without surgery.2 Resource-constrained settings predispose patients to reaching reproductive age without diagnosis or correction, and increase perioperative morbidity. Uncorrected TOF is challenging to manage during pregnancy and delivery, with increased risk of obstetric, cardiac and fetal complications.3 The incidence of preeclampsia in these patients is the same as for the global population.4 We describe the emergency management and caesarean delivery for a woman with uncorrected TOF, complicated by eclampsia and postpartum haemorrhage (PPH).