{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:07:08Z","timestamp":1788217628062,"version":"build-2803163510"},"reference-count":10,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,9]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2019-234055","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T01:59:36Z","timestamp":1596506376000},"page":"e234055","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Multidisciplinary approach in medicine: successful pregnancy in a patient with hyperinsulinism\/hyperammonaemia (HI\/HA) syndrome"],"prefix":"10.1136","volume":"13","author":[{"given":"Bernadette J M","family":"Benner","sequence":"first","affiliation":[{"name":"Metabolic Medicine Department, Center of Lysosomal and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mijke","family":"Bazelmans","sequence":"additional","affiliation":[{"name":"Obstetric Department, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidde","family":"Huidekoper","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Center of Lysosomal and Metabolic Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Langeveld","sequence":"additional","affiliation":[{"name":"Division of Clinical Endocrinology & Metabolism, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke","family":"Langendonk","sequence":"additional","affiliation":[{"name":"Metabolic Medicine Department, Center of Lysosomal and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Schoenmakers","sequence":"additional","affiliation":[{"name":"Obstetric Department, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"2025082700084977000_13.8.e234055.1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddx213"},{"key":"2025082700084977000_13.8.e234055.2","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-010-9146-0"},{"key":"2025082700084977000_13.8.e234055.3","unstructured":"Briggs GG . 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