Aldana-Valenzuela Carlos, Prieto-Pantoja José Alfredo, Hernández-Acevedo Angélica
Departamento de Neonatología, Hospital Materno Infantil de León, Guanajauto.
Ginecol Obstet Mex. 2010 Dec;78(12):692-6.
This is a clinical case presentation of a full term newborn infant who suffered severe hyponatremia and early seizures, associated with maternal fluid overload with electrolyte free solutions and high doses of oxytocin for labor augmentation. Although this condition has been recognized since the 1960's with isolated reports, this particular case has features that needs further investigation, not only for the unsually severe hyponatremia, but most importantly we think, for the prominent signs of fluid retention, the infant had, that suggest excessive antidiuretic activity probably due to oxytocin. These findings are consistent with syndrome of inappropriate secretion of antidiuretic hormone. Although until now there is no proof that oxytocin by itself produces this syndrome. We think the association is possible in certain clinical circumstances, such as those found in this case. We also, briefly discussed the pathophysiology of perinatal hyponatremia, the neonatal treatment of this condition and the current guidelines for the women in labor. Hyponatremia should not be considered a benign condition, since in the neonate, it may affect brain function.
这是一例足月儿的临床病例报告,该婴儿出现严重低钠血症和早期惊厥,与母亲使用无电解质溶液大量补液以及高剂量缩宫素加强宫缩有关。尽管自20世纪60年代以来就有关于这种情况的个别报道,但该特殊病例具有一些需要进一步研究的特征,不仅因为其低钠血症异常严重,更重要的是,我们认为,该婴儿出现的明显液体潴留迹象提示可能存在抗利尿活性过高,这可能是由于缩宫素所致。这些发现与抗利尿激素分泌不当综合征相符。尽管目前尚无证据表明缩宫素本身会导致该综合征。我们认为在某些临床情况下,比如本病例中的情况,两者之间存在关联是有可能的。我们还简要讨论了围生期低钠血症的病理生理学、该病症的新生儿治疗方法以及当前针对分娩期女性的指南。低钠血症不应被视为一种良性病症,因为在新生儿中,它可能会影响脑功能。