A multidisciplinary approach was undertaken in a case of a 38 year old G1P0 who came in at 33 1/7 weeks age of gestation with a chief complaint of persistent cough. Aside from persistent non-productive cough, the patient was otherwise asymptomatic despite a 2D echocardiogram of global hypokinesia and an ejection fraction of only 32 percent. Assessment was uterine pregnancy 33 1/7 weeks age of gestation, dilated cadiomyopathy with severe left ventricular dysfunction, congestive heart failure (CHF) Class 1A. Patient underwent primary low transverse cesarean section (vertical) with left uterine artery ligation and bilateral tubal ligation and delivered to a live baby boy with APGAR score of 6,9, birth weight of 1,581g, birth lenght of 42cm, maturity score of 35 weeks small for gestational age. This case attests to the importance of  pre conceptional counselling and prenatal care with active contributions of specialized obstetrician, cardiologist, internist and anesthesiologist