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Total surgical correction of the tetralogy of Fallot remains a most challenging and difficult problem in cardiac surgery. The present study, like others, indicates that this lesion can be corrected, and excellent anatomical and haemodynamic results can be obtained with an acceptable mortality.Results following total surgical correction in 45 consecutive patients are presented. The operative mortality was 13 %. The causes of death are analysed. Certain uncommon severe associated defects adversely influenced the outcome of the operation. The great majority of surviving patients are improved. Postoperative haemodynamic studies in eight patients revealed gratifying results.In 1955, after 10 years of palliative surgery using various shunt operations, Lillehei accomplished the first successful total surgical correction of the tetralogy of Fallot (Lillehei et al., 1955). The early mortality after the corrective operation was high, often in the range of 40% ; but today in most centres the operative mortality has been reduced to about 10°, (Kirklin, Wallace, McGoon, and DuShane, 1965;Malm et al., 1966;Zerbini, 1969 The symptomatology before operation is illustrated in Table II. Of the 45 patients, 39 had central cyanosis of varying degree and six were acyanotic.Most of these cases were moderately symptomatic and belonged to functional class ii to iii, while six had severe cyanosis with anoxic spells (class iv, NYHA classification). Three of the 45 patients had episodes of congestive failure, in two of whom aortic incompetence complicated the lesion. Two

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Cervical ectopic pregnancy is a rare condition that accounts for less than 0.1% of all ectopic pregnancies with high morbidity and mortality rate. We present a case of a 25 years old G5P3L2A1D1 with history of 9 weeks amenorrhoea and previous 3 caesarean sections (CS) presented with bleeding per vaginum for 2 days. Ultrasound examination revealed a ballooned-out cervical canal with a gestational sac containing foetus with cardiac activity present and an empty uterus with thickened endometrium with a typical hour-glass configuration of the uterus. Thus, the diagnosis of cervical ectopic pregnancy was made. Patient was complicated by haemorrhagic shock. Immediately hysterectomy was performed. Inj. PCV 4 unit and FFP 6 units were given and post-op- patient was shifted to ICU on ventilation support. In ICU, patient was kept on ventilation support for 4 days with vasopressor supports. Antibiotics, antacids, antiemetics, IV fluids, supportive care given. Patient was discharged on post-op day-7 with stable hemodynamics and healthy vaginal vault and stitch line. Improved ultrasound resolution and earlier detection has led to the development of more conservative treatments in non-severe cases that attempt to limit morbidity and preserve fertility.