title: [Labour analgesia in parturient with uncorrected tetralogy of Fallot: case report.].
abstract: OBJECTIVE
  Although tetralogy of Fallot is the most common cyanotic congenital heart disease, national publications correlating this condition with anesthetic practice are scarce. This report aimed at presenting a case of labor epidural analgesia in a patient with uncorrected tetralogy of Fallot diagnosed during gestation.
  
  
  METHODS
  Patient 26 years old, 1.54 m, 56 kg, 32 weeks and 5 days of gestational age, who had been diagnosed with tetralogy of Fallot during gestation. Patient was admitted in labour. After obstetric evaluation and decision for natural birth, epidural analgesia was performed with 0.125% bupivacaine associated to 100microg fentanyl through a catheter. Patient gave birth 1 hour and 30 minutes after the procedure. The newborn weighed 1485 grams and had an Apgar score of 6 and 8 at one and five minutes, respectively. Patient remained stable, with no hemodynamic or ECG changes.
  
  
  CONCLUSIONS
  Selecting the appropriate anesthetic technique is extremely important when managing patients with uncorrected tetralogy of Fallot. Favorable uterine dynamics and cervical conditions, particularly in patients with no history of syncope, are critical findings for adequate labour analgesia indication.
authors.affiliation: Serviço de Anestesiologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo.
authors.forename: Florentino Fernandes
authors.initials: FF
authors.lastname: Mendes
authors.forename: Carlos Alberto T
authors.initials: CA
authors.lastname: Farias
authors.forename: Daniel
authors.initials: D
authors.lastname: Segabinazzi