Massive obstetric hemorrhage in a case with placenta accreta

 Post-partum is one of the common causes of maternal mortality. Massive obstetrics hemorrhage may occur due to several etiologies such as Placenta Accreta. Massive transfusion protocols for obstetrics can reduce mortality and morbidity rate.   A 28 year old patient who was an elective candidate for second cesarean without any particular disease was under spinal anesthesia and gave birth to a healthy baby. But after 25 minutes from the onset of the operation, the patient suffered from a marked drop in blood pressure and decrease in consciousness.  Due to hemorrhage shock od an estimated blood loss of nearly 3500cc, she was intubated and prescribed isotonic and hypertonic fluids, colloids and blood components. Her diagnosis was placentra accreta and to control hemorrhage, hysterectomy was done.     Preoperative suspension for Placenta Accreta abnormalities should alert the anesthesia provider to potential massive blood loss. Preoperative effective communication among all obstetric caregivers is imperative.