we present a case of a 32 year old woman with history of anorexia nervosa who was managed at our hospital.
She had treatment in italy in her early twenties and had long term sequel of osteopenia. she was treated with the contraceptive pill accordingly.
since she was underweight and amenhorric she was advsied to gain weight to a minimum of 55 kg. She had ovarian stimulation and transfer of two embryos with assisted conception resulting in a DCDA twin pregnancy.
She was initially seen for a medical consult at 27 weeks. She had gained minimal weight in this time. she had nutritional supplements and regular dietician review with a weight gain of about 8 kg at 35 weeks.
She had a diagnosis of intrahepatic cholestatsis and IUGRwith growth of both twins around the 30 th percentile.
She had an induced vaginal delivery of twins with weights of 2.4 and 2.3 KG and the babies spent two days in NICU. breast feeding was established with on going supportive nutritional treatment.
This case highlights the need for multidisciplinary care of patients such as our patient.
We aim to discuss complications that can be encountered in these patients in pregnancy.