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.

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doi.org/10.1136/bcr-2019-234055, hdl.handle.net/1765/129432
BMJ Case Reports
Erasmus MC: University Medical Center Rotterdam

Benner, B.J.M. (Bernadette J M), Bazelmans, M., Huidekoper, H. H., Langeveld, M., Langendonk, J., & 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