Ganzevoort J W, Hoogerwaard E M, van der Post J A M
Afd. Verloskunde en Gynaecologie, Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.660, 1100 DD Amsterdam.
Ned Tijdschr Geneeskd. 2002 Aug 3;146(31):1453-6.
A 34-year-old pregnant patient, admitted with severe pre-eclampsia and the 'haemolysis, elevated liver enzymes, low platelets' (HELLP) syndrome at 31 weeks gestational age, was treated with magnesium sulphate for imminent eclampsia. The further management was aimed at prolonging gestation. During treatment, a delirium developed with myoclonus. As the foetal condition deteriorated, caesarean section was performed. Afterwards, the delirium proved to have been due to hypocalcaemia. After appropriate treatment the patient recovered. In pre-eclampsia, the calcium metabolism is disturbed. Hypermagnesaemia inhibits parathyroid hormone secretion and can therefore cause hypocalcaemia. In rare cases, this may cause a delirium, which is unusual in pre-eclampsia. If the clinical (neurological) picture in a pregnant woman with severe pre-eclampsia, who is receiving treatment with magnesium sulphate, is not fully understood, hypocalcaemia should be considered.
一名34岁的孕妇，孕31周时因重度子痫前期及“溶血、肝酶升高、血小板减少”（HELLP）综合征入院，因即将发生子痫而接受硫酸镁治疗。进一步的治疗目标是延长孕周。治疗期间，患者出现谵妄并伴有肌阵挛。随着胎儿情况恶化，行剖宫产术。术后证实谵妄是由低钙血症引起的。经过适当治疗，患者康复。子痫前期患者存在钙代谢紊乱。高镁血症会抑制甲状旁腺激素分泌，从而导致低钙血症。在极少数情况下，这可能会引起谵妄，而这在子痫前期并不常见。如果正在接受硫酸镁治疗的重度子痫前期孕妇的临床（神经学）表现未被充分理解，应考虑低钙血症的可能。
