This case illustrates the importance of multidisciplinary counselling and management of pregnancies in women with complex medical conditions, especially concerning women with cognitive impairment. We present a woman with hyperinsulinism/hyperammonaemia (HI/HA) syndrome. This syndrome is characterised by recurrent episodes of hypoglycaemia and elevated ammonia levels, which are potentially harmful to both the patient and a developing fetus. We describe a successful multidisciplinary approach during the pregnancy of a mentally challenged patient with HI/HA syndrome. This case illustrates the importance of personalised counselling during the preconception period and emphasises to include all disciplines involved in the medical and daily care of such a patient. In our case, the extensive multidisciplinary care during the preconception period, pregnancy, delivery and postpartum period resulted in a good maternal and neonatal outcome.

Additional Metadata
Keywords metabolic disorders, pregnancy
Persistent URL dx.doi.org/10.1136/bcr-2019-234055, hdl.handle.net/1765/129432
Journal BMJ Case Reports
Organisation Erasmus MC: University Medical Center Rotterdam
Citation
Benner, B.J.M. (Bernadette J M), Bazelmans, M, Huidekoper, H.H, Langeveld, M, Langendonk, J.G, & Schoenmakers, S. (2020). Multidisciplinary approach in medicine: successful pregnancy in a patient with hyperinsulinism/hyperammonaemia (HI/HA) syndrome. BMJ Case Reports, 13(8). doi:10.1136/bcr-2019-234055