Recombinant activated factor VII (rFVIIa; NovoSeven(R)) was successfully used in 3 patients with massive obstetric hemorrhage caused by placenta previa accreta, rupture of the uterine wall and preeclampsia complicated by HELLP syndrome. rFVIIa was administered intravenously to the 3 patients after all hemostatic attempts failed, they were critically ill multi-transfused and close to exsanguination. In one patient this treatment was life-saving and in the other two it helped to control the bleeding. rFVIIa is a promising new agent for hemorrhage control in massive obstetric bleeding.