Keywords:
Pulmonary arterial hypertension, pregnancy, cesarean delivery, obstetric anesthesia, right ventricular function, hemodynamic management, CSE, high-risk obstetrics

Description:
Case-based presentation of cesarean delivery in a patient with severe idiopathic pulmonary arterial hypertension, highlighting a physiology-driven anesthetic strategy with careful hemodynamic control, incremental uterotonic use, and multidisciplinary coordination to mitigate risk of right ventricular failure.