Neuraxial anaesthesia for lower segment caesarean section in three parturients with uncorrected tetralogy of Fallot.

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. The physiological cardiovascular changes of pregnancy may worsen right-to-left shunting and haemodynamic instability in women with uncorrected TOF, increasing maternal and fetal risk. We report a case series of three parturients with uncorrected TOF managed at our institution using a combined low-dose spinal and epidural anaesthetic technique. In these cases, the technique was associated with adequate surgical anaesthesia and stable haemodynamics, allowing avoidance of general anaesthesia.