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Multidisciplinary approach in medicine: successful pregnancy in a patient with hyperinsulinism/hyperammonaemia
Bernadette J M Benner1, Mijke Bazelmans2, Hidde Huidekoper3
1Metabolic Medicine Department, Center of Lysosomal and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands.
Abstract:
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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