Tetralogy of Fallot (TOF) is the most common type of cyanotic congenital heart disease. The physiologic consequences that accompany the disease increase the risk for perioperative complications, and mortality is increased in the mere 3% that survive into adulthood without correction. This case report highlights the anesthetic management of a rare case of uncorrected TOF in a 50-year-old female with two-pillow orthopnea, occasional palpitations, and exertional dyspnea who underwent a major gynecologic procedure. Thorough understanding and careful planning were performed to balance anesthesia, accounting for shifts brought about by the long-term hypoxia and decreased pulmonary blood flow, affording an uneventful perioperative course and recovery.

Tetralogy of Fallot (TOF) is the most common type of cyanotic congenital heart disease. The physiologic consequences that accompany the disease increase the risk for perioperative complications, and mortality is increased in the mere 3% that survive into adulthood without correction. This case report highlights the anesthetic management of a rare case of uncorrected TOF in a 50-year-old female with two-pillow orthopnea, occasional palpitations, and exertional dyspnea who underwent a major gynecologic procedure. Thorough understanding and careful planning were performed to balance anesthesia, accounting for shifts brought about by the long-term hypoxia and decreased pulmonary blood flow, affording an uneventful perioperative course and recovery.

Tetralogy of Fallot (TOF) is the most common type of cyanotic congenital heart disease. The physiologic consequences that accompany the disease increase the risk for perioperative complications, and mortality is increased in the mere 3% that survive into adulthood without correction. This case report highlights the anesthetic management of a rare case of uncorrected TOF in a 50-year-old female with two-pillow orthopnea, occasional palpitations, and exertional dyspnea who underwent a major gynecologic procedure. Thorough understanding and careful planning were performed to balance anesthesia, accounting for shifts brought about by the long-term hypoxia and decreased pulmonary blood flow, affording an uneventful perioperative course and recovery.

Gorham–Stout disease (GSD) is a rare bone condition characterized by osteolysis, angiomatosis, and lymphangiomatosis. This paper presents a case, in which a 38-year-old pregnant female with GSD underwent cesarean delivery due to a low-lying placenta. Her medical history, which included a previous surgical intervention for an intraoral mass attributed to GSD and a course of radiotherapy, suggested potential difficulties in both securing the airway and instituting neuraxial anesthesia, as well as potential complications, including perioperative bleeding. In this case, tailored anesthetic management strategies and interdisciplinary collaboration helped achieve optimal outcomes for the mother and successful delivery of a healthy baby. In particular, combined spinal and epidural anesthesia avoided the need for GA, and provided a rapid onset and titratable anesthesia with minimal systemic effects. Furthermore, vigilant monitoring of hemodynamic parameters was also paramount in mitigating the risks associated with both GSD and pregnancy itself.

Gorham–Stout disease (GSD) is a rare bone condition characterized by osteolysis, angiomatosis, and lymphangiomatosis. This paper presents a case, in which a 38-year-old pregnant female with GSD underwent cesarean delivery due to a low-lying placenta. Her medical history, which included a previous surgical intervention for an intraoral mass attributed to GSD and a course of radiotherapy, suggested potential difficulties in both securing the airway and instituting neuraxial anesthesia, as well as potential complications, including perioperative bleeding. In this case, tailored anesthetic management strategies and interdisciplinary collaboration helped achieve optimal outcomes for the mother and successful delivery of a healthy baby. In particular, combined spinal and epidural anesthesia avoided the need for GA, and provided a rapid onset and titratable anesthesia with minimal systemic effects. Furthermore, vigilant monitoring of hemodynamic parameters was also paramount in mitigating the risks associated with both GSD and pregnancy itself.

Extrauterine abdominal pregnancies occur when the fertilized ovum implants directly into the peritoneal cavity. They are rare, with its incidence being just 1 in 10,000 live births worldwide, and only 0.43% of all documented ectopic pregnancies in the Philippines. This poses a challenge in anesthesia because of the risk of massive hemorrhage the abnormal implantation brings about. This case report presents the anesthetic management of a 29-year-old G3P2 (2002) diagnosed case of 26-week and 5-day gestation viable abdominal pregnancy who underwent abdominal fetal extraction under combined general and epidural anesthesia. Along with the utilization of a multidisciplinary approach, goal-directed fluid therapy, and massive transfusion protocol, this management has been shown to be successful and safe for both the mother and the fetus.

Physical trauma significantly influences pregnancy outcomes leading to feto-maternal morbidity or mortality. A 20-year-old G1P0 (33 weeks 4/7 days AOG) COVID- 19 suspect was accidentally impaled by a falling metal rod while aboard her electric scooter. This paper highlights the peculiarities of anesthetizing a parturient with an impaled foreign body in the abdominal cavity while ensuring the well-being of the fetus amidst the challenges of the COVID-19 pandemic.

The management of the pregnant patient with a brain tumor must be individualized for each patient. It is a tailored and coordinated multi speciialty effort where well-defined seams are fitted for the individual and the outfit appropriate for the occasion. In the end, what matter most is the best appropriate management that is rational and safe is given for both individuals.
Human ; Adult ; PREGNANCY ; BRAIN NEOPLASMS ; MENINGIOMA ; PREGNANCY, HIGH- RISK