Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
BMJ Case Rep. 2021 Aug 17;14(8):e244688. doi: 10.1136/bcr-2021-244688.
Pre-eclampsia is a common pregnancy complication with many associated maternal and fetal risks, yet its pathophysiology remains poorly understood. Hyponatraemia is a rarely described finding in pre-eclampsia that has been associated with both maternal and fetal complications and medically indicated delivery. We present a case of hyponatraemia in a patient admitted for induction of labour for gestational hypertension, which developed into pre-eclampsia with severe features requiring magnesium sulfate therapy for seizure prophylaxis. The patient's hyponatraemia resolved with delivery, fluid restriction and serial sodium monitoring. Adjustment to the components of the patient's magnesium sulfate infusion was made to reduce free water intake and avoid further exacerbation of her hyponatraemia. While there is currently no recommendation to routinely monitor sodium levels in hypertensive disorders of pregnancy, careful consideration of this potential finding in cases of pre-eclampsia should be given due to the overlap between symptoms of hyponatraemia and cerebral symptoms of pre-eclampsia.
子痫前期是一种常见的妊娠并发症，与许多母体和胎儿风险相关，但它的病理生理学仍未被很好地理解。低钠血症是子痫前期中很少描述的一种发现，与母体和胎儿并发症以及医学上需要的分娩有关。我们报告了一例因妊娠高血压入院引产的患者出现低钠血症，随后发展为严重特征的子痫前期，需要硫酸镁治疗以预防抽搐。患者的低钠血症随着分娩、液体限制和连续钠监测而得到解决。调整了患者硫酸镁输液的成分，以减少自由水的摄入，并避免进一步加重低钠血症。虽然目前没有建议在妊娠高血压疾病中常规监测钠水平，但由于低钠血症的症状和子痫前期的脑部症状之间存在重叠，对于子痫前期病例中这种潜在发现应给予仔细考虑。
