Sutton R A, Schonholzer K, Kassen B O
Department of Medicine, University of British Columbia, Vancouver, Canada.
Am J Kidney Dis. 1993 Apr;21(4):444-5. doi: 10.1016/s0272-6386(12)80275-7.
Plasma osmolality normally decreases in early pregnancy, reaching a minimum at approximately 10 weeks and remaining depressed until term. This is associated with a mean decrease of 4 mEq/L in the plasma sodium level, and with an altered threshold for arginine vasopressin (AVP) release and for thirst. We describe a patient who developed more severe hyponatremia (120 mEq/L), which accompanied the development of hypertension and edema at 37 weeks in her fourth pregnancy. Hyponatremia and hypo-osmolality were associated with marked elevation of the plasma AVP level. The hyponatremia and elevated AVP level resolved after the delivery of the infant. To our knowledge, this is the first reported example of transient inappropriate antidiuretic hormone secretion (SIADH) associated with pregnancy.
血浆渗透压在妊娠早期通常会下降，在大约10周时降至最低，并一直保持较低水平直至足月。这与血浆钠水平平均下降4 mEq/L有关，同时也与精氨酸加压素（AVP）释放阈值和口渴阈值的改变有关。我们描述了一名患者，她在第四次怀孕37周时出现了更严重的低钠血症（120 mEq/L），同时伴有高血压和水肿。低钠血症和低渗透压与血浆AVP水平显著升高有关。婴儿出生后，低钠血症和升高的AVP水平得到缓解。据我们所知，这是首次报道的与妊娠相关的短暂性抗利尿激素分泌不当综合征（SIADH）病例。
