Massive Blood Transfusion in a Case of Ruptured Uterus - A Multidisciplinary Challenge

Background: Obstetric haemorrhage remains a leading cause of maternal morbidity and mortality, often requiring rapid multidisciplinary coordination. Case: We present a case of a 42-year-old multigravida at 32+6 weeks gestation who presented in hypovolemic shock secondary to ruptured placenta previa with hemoperitoneum. The patient underwent emergency caesarean section followed by obstetric hysterectomy. Anaesthetic management was focused on airway control, massive transfusion protocol, and haemodynamic stabilisation using multiple inotropes and vasopressors. A total of 8 units of packed red blood cells, 10 units of fresh frozen plasma, and 8 units of random donor platelets were transfused intraoperatively. Conclusion: Early recognition, activation of the massive transfusion protocol, and multidisciplinary coordination are critical in successful management of catastrophic obstetric haemorrhage.