Alake Oluwaseyi, Rana Reena, Jain Anoo, Chakkarapani Ela
Regional Neonatal Intensive Care Unit, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Regional Neonatal Intensive Care Unit, St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
BMJ Case Rep. 2021 Mar 17;14(3):e237213. doi: 10.1136/bcr-2020-237213.
Misguided encouragement to consume large volumes of water during labour for pain relief results in dilutional hyponatraemia in mothers and their babies presenting with neurological dysfunction. We report three babies who were encephalopathic with seizures in the background of hyponatraemia secondary to maternal ingestion of large volumes of water and mild perinatal asphyxia. All babies underwent therapeutic hypothermia in addition to sodium supplementation with fluid restriction. Their neurodevelopment was appropriate for age. This case series highlights the dilemma that could arise with hyponatraemic encephalopathy and mild perinatal asphyxia in the first 6 hours of life, which is the window of opportunity for therapeutic hypothermia for hypoxic-ischaemic encephalopathy. It is important to educate pregnant mothers in labour on the adverse effects of excessive fluid ingestion.
在分娩过程中，为缓解疼痛而错误地鼓励大量饮水会导致母亲及其出现神经功能障碍的婴儿发生稀释性低钠血症。我们报告了三名婴儿，他们在母亲大量饮水继发低钠血症以及轻度围产期窒息的背景下出现脑病并伴有癫痫发作。所有婴儿除了补充钠并限制液体摄入外，还接受了治疗性低温治疗。他们的神经发育与年龄相符。该病例系列突出了在出生后6小时内低钠血性脑病和轻度围产期窒息可能出现的困境，这是针对缺氧缺血性脑病进行治疗性低温治疗的时机窗口。对分娩中的孕妇进行过度饮水不良影响的教育很重要。
