Yingying Pu1, Xia Wang2, Hualei Bu2, Wenzhe Zhang2, Ruihui Lu2, Shuquan Zhang3. 1. Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China. 2. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China. 3. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China. zhangshuquan0326@126.com.
Abstract
PURPOSE: To summarize the clinical characteristics and treatments of preeclampsia complicated with hyponatremia. METHODS: We reported a new case of preeclampsia complicated with severe hyponatremia; searched for relevant articles from the PubMed, Scopus and Cochrane databases; and reviewed all reported cases. RESULTS: Twenty-one reported cases were found. Our case is 22nd, and the serum sodium level in this case was the lowest reported. After treatment comprising fluid restriction, hypertonic saline and caesarean section, a relatively good outcome was achieved. In all reported cases, SIADH, preeclampsia or the combined effect of preeclampsia and induced nephrotic syndrome were the speculated pathogeny. Termination was performed due to adverse manifestations; six cases underwent transvaginal deliveries, and sixteen cases underwent caesarean section. Fifteen patients recovered from hyponatremia within 72 h after delivery. CONCLUSION: The pathogenesis of hyponatremia occurring in patients with preeclampsia is still unclear. Termination of the pregnancy led to a stabilization of the sodium level, ICU monitoring was necessary, and fluid restriction and hypertonic saline intake were applied; however, there was no evidence of the effectiveness of the treatments.
PURPOSE: To summarize the clinical characteristics and treatments of preeclampsia complicated with hyponatremia. METHODS: We reported a new case of preeclampsia complicated with severe hyponatremia; searched for relevant articles from the PubMed, Scopus and Cochrane databases; and reviewed all reported cases. RESULTS: Twenty-one reported cases were found. Our case is 22nd, and the serum sodium level in this case was the lowest reported. After treatment comprising fluid restriction, hypertonic saline and caesarean section, a relatively good outcome was achieved. In all reported cases, SIADH, preeclampsia or the combined effect of preeclampsia and induced nephrotic syndrome were the speculated pathogeny. Termination was performed due to adverse manifestations; six cases underwent transvaginal deliveries, and sixteen cases underwent caesarean section. Fifteen patients recovered from hyponatremia within 72 h after delivery. CONCLUSION: The pathogenesis of hyponatremia occurring in patients with preeclampsia is still unclear. Termination of the pregnancy led to a stabilization of the sodium level, ICU monitoring was necessary, and fluid restriction and hypertonic saline intake were applied; however, there was no evidence of the effectiveness of the treatments.
Entities:
Keywords:
Hyponatremia; Preeclampsia; Pregnancy; Severe
Authors: Carlos R Camara-Lemarroy; Alejandro de Leon-Cruz; Rene Rodriguez-Gutierrez; Dionicio A Galarza-Delgado Journal: Gynecol Endocrinol Date: 2013-05-24 Impact factor: 2.260