text:  After consultation with Cardiology as well as Anesthesia on call that evening   it was decided to transfer the patient to the ICU for intensive monitoring . Central IV access was obtained . The patient was carefully diuresed over the next 48 hours . Symptoms of congestive heart failure gradually abated over the next 48 to 72 hours . The patient was given antenatal corticosteroids for fetal lung maturity . A Neonatology consultation was obtained during the course of the hospitalization . After discussion   it was decided to attempt to obtain 28 weeks gestation and then deliver electively by cesarean section given the decompensation in the third trimester . The patient underwent primary low transverse cesarean section on 2014-05-19 at approximately 28 weeks gestation . The cesarean section was performed on the West Campus in the Cardiothoracic Surgical Suite . This was performed in this location in case any acute cardiac decompensation occurred during the time of cesarean section . Cardiothoracic Surgery was on standby during the surgery . The patient went to the cardiac Intensive Care Unit on the West Campus postoperatively . She did well during the postoperative period . She required several episodes of diuresis due to increasing shortness of breath on postoperative day 1 and postoperative day 2 due to worsening symptoms of shortness of breath from fluid shifts that normally occur during the postpartum period . The patient was transferred to the West Campus on postoperative day 2 in stable condition . She did well during the remainder of her postoperative course and was continued on her medication regimen that she had been on during the antepartum period . She was discharged to home on postoperative day 4 . She was to followup with Maternal Fetal Medicine in 5 to 7 days . She had followup with her primary cardiologist in Shaugnessy-Kaplan Rehab Hospital scheduled for 1 week postoperatively . Of note   the patient also underwent tubal ligation at the time of cesarean section .