严重无症状的产妇产前低钠血症导致新生儿惊厥：预防胜于治疗。
Severe asymptomatic maternal antepartum hyponatremia leading to neonatal seizures: prevention is better than cure.
作者信息
Valerio Enrico, Fantinato Margherita, Giovannini Irene Alba Beatrice, Baraldi Eugenio, Chiandetti Lino
机构信息
Department of Woman and Child Health, Medical School, University of Padua, Via Giustiniani, 3, 35128 Padova, Italy.
出版信息
Matern Health Neonatol Perinatol. 2015 Nov 4;1:25. doi: 10.1186/s40748-015-0027-0. eCollection 2015.
BACKGROUND
Pre-delivery maternal electrolyte derangements may reflect themselves in the newborn, since placental homeostasis determines electrolyte equilibrium between mother and fetus.
CASE PRESENTATION
A term newborn, transferred to our Neonatal Intensive Care Unit 1 h after birth for an apnoea episode, presented with initially left-sided, and subsequently generalized tonic-clonic seizures due to severe hyponatremia (119 mmol/L). Seizures rapidly ceased after electrolyte correction plus a phenobarbital bolus. Deep hyponatremia was also detected in the mother (123 mmol/L).
CONCLUSIONS
As placental homeostasis determines electrolytes equilibrium between mother and fetus, obstetrics and neonatologists should be aware that any maternal dyselectrolytemia will reflect itself in the newborn; hence, it is fundamental to detect possible maternal electrolyte imbalances before delivery, in order to be prepared to timely correction of electrolyte derangements in the newborn.
背景
分娩前母体电解质紊乱可能会在新生儿身上体现出来，因为胎盘的内环境稳定决定了母婴之间的电解质平衡。
病例报告
一名足月儿，出生后1小时因呼吸暂停发作被转入我们的新生儿重症监护病房，因严重低钠血症（119 mmol/L）最初出现左侧抽搐，随后发展为全身性强直阵挛发作。在电解质纠正加苯巴比妥推注后，癫痫发作迅速停止。母亲也被检测出严重低钠血症（123 mmol/L）。
结论
由于胎盘的内环境稳定决定了母婴之间的电解质平衡，产科医生和新生儿科医生应意识到任何母体电解质紊乱都会在新生儿身上体现出来；因此，在分娩前检测可能存在的母体电解质失衡至关重要，以便为及时纠正新生儿电解质紊乱做好准备。
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