Introduction: This report describes the challenges of treating a pregnant woman who had a rare case of critical
placenta accreta with concurrent Cromer system anti-Tc(a) and anti-Kidd A alloantibodies. No previous case of such
alloimmunization in a patient with placenta accreta has been reported.
Case presentation: A 28-year-old African woman with anti-Cromer Tc(a) antibodies, anti-Kidd A antibodies and
placenta accreta was admitted to the obstetric emergency department at our university hospital with persistent
vaginal bleeding. Her rare Cromer blood group system antibodies had been diagnosed 1 month earlier; no compatible
blood had been found despite a worldwide search. We performed a cesarean section after placement of Fogarty
balloons in her uterine arteries with preoperative endovascular interventional radiology. Other therapeutic interventions
included preoperative iron administration to raise hemoglobin and the scheduled predeposit of autologous blood.
Intraoperative therapeutic management was aimed at preventing coagulopathy and massive bleeding. With the use of
alternative medical techniques determined during perioperative planning, her intraoperative blood loss was only
1000mL, despite the placenta accreta. She was discharged from the hospital 4 days after cesarean section.