A high-risk cesarean delivery involving complex cardiac disease and two exceptionally large uterine fibroids highlights how coordinated surgical and interventional radiology care can help manage severe obstetric hemorrhage while preserving the uterus. At a private hospital in Manipal, Karnataka, a multidisciplinary team delivered a baby girl to a 32-year-old woman at 37 weeks of gestation. The pregnancy was complicated by a previously stented coarctation of the aorta, a bicuspid aortic valve, and long-standing hypertension.

Her obstetric history also included two ectopic pregnancies and surgical removal of one fallopian tube. Given the substantial risk of hemorrhage and its potential cardiac consequences, the team planned the delivery with input from obstetrics and gynecology, anesthesiology, and interventional radiology specialists. Before the cesarean section, interventional…