Massive transfusion in placenta percreta in obstetric patients, how far can an anesthesiologist go?

Massive bleeding during obstetric surgery such as hysterectomy is the number one cause of maternal mortality and morbidity. Fluid resuscitation is mandatory in this case. Massive Transfusion Protocol is an important live-saving management in massive blood loss in obstetric case. We present a case of a healthy 38-year-old female with third pregnancy who was scheduled to have a Sectio Caesarean and hysterectomy procedure due to placenta acretta and have a massive bleeding intraoperatively.