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Severe hyponatremia in preeclampsia: a case report and review of the literature

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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Author notes

  1. Yingying Pu and Xia Wang contributed equally.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China

    Yingying Pu

  2. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China

    Xia Wang, Hualei Bu, Wenzhe Zhang, Ruihui Lu & Shuquan Zhang

Authors
  1. Yingying Pu
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  2. Xia Wang
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  3. Hualei Bu
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  4. Wenzhe Zhang
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  5. Ruihui Lu
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  6. Shuquan Zhang
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Contributions

YP: Manuscript writing; XW: Manuscript editing; HB: Protocol development; WZ, RL: Data collection and analysis; SZ: Protocol development.

Corresponding author

Correspondence to Shuquan Zhang.

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The authors declare that they have no conflict of interest.

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The study was approved by the ethics committee of Qilu Hospital of Shandong University.

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Informed consent was obtained from the patient.

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Pu, Y., Wang, X., Bu, H. et al. Severe hyponatremia in preeclampsia: a case report and review of the literature. Arch Gynecol Obstet 303, 925–931 (2021). https://doi.org/10.1007/s00404-020-05823-9

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  • DOI: https://doi.org/10.1007/s00404-020-05823-9

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