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This presentation is a case study of a patient with an undiagnosed invasive placenta. Interdisciplinary simulations, competencies, and screening algorithms put in place in anticipation of a massive hemorrhage contributed to the outcome of this patient. This presentation is meant to bring a better understanding of the placenta acreta spectrum, interventions to stabilize a hemodynamically unstable patient, and steps to coordinate unit preparedness for a massive hemorrhage on any obstetric unit.