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A CASE OF COMPLETE HEART BLOCK IN PREGNANCY Dr. Kalyani Krishnan ,Govt RSRM lying in hospital and medical college INTRODUCTION: Complete heart block is a conduction disorder characterized by a random relationship between the atrial and the ventricular activation where the atrial impulses are not conducted to the ventricle. Maternal complete heart block (CHB),which manifests for the first time during pregnancy and peurperium, poses a challenge to the obstetrician and calls for a multidisciplinary approach involving the cardiologist and anesthesiologist. CASE REPORT: A 28-year-old Rh negative primigravida with MCDA twins was referred to our institution for safe confinement at 33 weeks 5 days of gestation as a case of Preterm pain with suspected Wenckebach Heart block. ECG done showed Complete heart block with features suggestive of Left ventricular Hypertrophy, followed by an Echocardiogram showed ,EF 65%,with no RWMA and normal LVF. Investigations: An ultrasound with doppler showed a MCDA Twins with good biophysical profile. ECG showed a complete heart block, 68 bpm, regular PP interval, irregularly irregular RR interval, normal QRS duration, above AVN block,no ST changes.Echo showed only rhythm abnormality. Elective LSCS was planned at 36 weeks 3 days on 1/8/24. Day of surgery: Temporary pacemaker insertion under fluoroscopy guidance was done through transfemoral approach.In the presence of multidisciplinary team and under general anaesthesia an elective caesarean delivery proceeded in usual way to deliver an alive, preterm, boy baby of birth weight 2.510 kg and an alive, preterm, boy baby of birth weight 2.985 kg who cried immediately Post operatively patient was monitored by multidisciplinary team.On POD-1 the temporary pacemaker lead was removed Post operative period was uneventful. CONCLUSION : Although a rare scenario ,A multidisciplinary approach involving the obstetrician,cardiologist and anesthesiologist can be life saving in such cases.