医学
抗利尿药
子痫前期
尿渗透压
尿钠
蛋白尿
内科学
内分泌学
低钠血症
激素
妊娠期
尿
怀孕
液体限制
抗利尿激素分泌不当综合征
产科
肾
生物
遗传学
作者
Holly Wilson,L.E. Shutt
标识
DOI:10.1016/j.ijoa.2007.02.005
摘要
While preeclampsia is common in pregnancy, associated hyponatraemia is rare with very few cases reported in the literature. We report the case of a previously healthy nulliparous woman who presented at 34 weeks' gestation with hypertension and proteinuria. On admission her serum sodium was 122mmol/L and by day 6, in the absence of fluid restriction, it had fallen to 116mmol/L. Urine and plasma osmolalities suggested a syndrome of inappropriate antidiuretic hormone secretion. She was delivered on the sixth day by caesarean section because of fetal distress and worsening preeclampsia. Postoperatively fluid intake was restricted and her sodium normalised within 48h. Preeclampsia results in a low effective circulating volume which can cause a non-osmotic release of antidiuretic hormone and a resultant increase in the urine/plasma osmolality ratio to greater than 1. In patients with preeclampsia, hyponatraemia may further increase the risk of seizures and should therefore be closely monitored and treated without delay.
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