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The obstetrical follow-up of patients with severe hypofibrinogenemia requires a multidisciplinary collaboration because of potential maternal–fetal complications (recurrent miscarriages, intrauterine fetal demise, post-partum hemorrhage, thrombosis). We report the obstetrical management of a multiparous patient with severe congenital hypofibrinogenemia associated with a platelet disorder (abnormal phospholipid externalization). A therapeutic strategy based on a biweekly administration of fibrinogen concentrates combined with enoxaparin and aspirin allowed the maintenance of pregnancy. But this pregnancy became complicated by a placenta percreta requiring a salvage hysterectomy with an appropriate hemorrhage prophylaxis.