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

Human ; Female ; Adult ; Gestational Age ; Birth Weight ; Uterine Artery ; Anesthesiologists ; Cardiologists ; Sterilization, Tubal ; Hypokinesia ; Stroke Volume ; Maternal Age ; Parturition ; Ventricular Dysfunction, Left ; Heart Failure

BACKGROUND: Preterm birth is a major cause of perinatal morbidity and mortality. Tocolytic drugs are used to suppress uterine contractions. The most widely used tocolytics in the Philippines are betamimetics, such as Terbutaline, which are known to have high incidence of maternal adverse effects. Nifedipine, a calcium channel blocker, is an alternative tocolytic with potentially similar efficacy and fewer maternal side effects than terbutaline.
CONCLUSION: Terbutaline and Nifedipine appeared to be equally effective tocolytic agents. However, nifedipine had tile advantage of lesser incidence of maternal adverse effects.

Human ; Tocolytic Agents ; Nifedipine ; Terbutaline ; Calcium Channel Blockers ; Uterine Contraction ; Adrenergic Beta-agonists ; Maternal Inheritance ; Iatrogenic Disease