Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
Department of Medicine, Mater Dei Hospital, Msida, Malta.
BMJ Case Rep. 2020 Dec 31;13(12):e237827. doi: 10.1136/bcr-2020-237827.
A 41-year-old woman was diagnosed with pre-eclampsia at 35 weeks gestation. She was treated with antihypertensives but, unfortunately, her condition became complicated by severe hyponatraemia. Her sodium levels rapidly dropped to 125 mmol/L. The cause for the hyponatraemia was the syndrome of inappropriate antidiuretic hormone secretion. She was initially managed with fluid restriction, but an emergency caesarean section was necessary in view of fetal distress. Her sodium levels returned to normal within 48 hours of delivery.Pre-eclampsia is rarely associated with hyponatraemia. A low maternal sodium level further increases the mother's risk for seizures during this state. Additionally, the fetal sodium rapidly equilibrates to the mother's and may result in fetal tachycardia, jaundice and polyhdraminios. All these factors may necessitate an emergency fetal delivery.
一位 41 岁女性在 35 周妊娠时被诊断为先兆子痫。她接受了降压治疗，但不幸的是，她的病情因严重低钠血症而变得复杂。她的钠水平迅速降至 125mmol/L。低钠血症的原因是抗利尿激素分泌不当综合征。她最初通过限制液体摄入进行治疗，但由于胎儿窘迫，需要紧急剖宫产。她的钠水平在分娩后 48 小时内恢复正常。先兆子痫很少与低钠血症有关。低母体钠水平进一步增加了母亲在此状态下癫痫发作的风险。此外，胎儿钠迅速与母亲平衡，可能导致胎儿心动过速、黄疸和多胎羊水过多。所有这些因素都可能需要紧急分娩胎儿。
