**2. Demographics of high-risk patients**

Approximately 60% of women with MAP will experience significant morbidity, including blood transfusion, urologic injury, infection, intensive care unit admission, and readmission. A 15% of obstetric hemorrhage requiring blood transfusion are due to MAP [11]. The majority of patients with MAP will undergo invasive procedures, have extensive blood loss and require massive blood transfusion [2, 11]. A 90% of patients with placenta percreta who undergo cesarean hysterectomy will require blood transfusion due to intraoperative blood losses greater than three liters, with median transfusion of 7 units of red blood cells [12, 13]. The morbidity and mortality associated with MAP is even more devastating when blood transfusion is not an option, either from lack of resources or patient refusal. Patients decline blood transfusions for a variety of reasons, most commonly due to religious grounds, such as for Jehovah's Witnesses. For these patients, the risk of mortality due to obstetric hemorrhage is 130 times greater than in the normal population [5].
