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[Anesthesia for cesarean section in a patient with transient diabetes insipidus].
Masui. 2003 Feb; 52(2):158-61.M

Abstract

A 32-year-old pregnant female was admitted to our hospital at 32 week gestation and was scheduled for emergent cesarean section because of fetal distress. She had been suffering hydrodipsia and dry mouth, and had lost 4 kg in 2 weeks. Hypernatremia, hyperchloremia, and lower urinary specific gravity were preoperatively noted. Her electrolyte imbalance was partially corrected by the infusion of 1400 ml of 5% glucose solution and 500 ml of acetated Ringer's solution, but unexpected hyperglycemia; 440 mg.dl-1, appeared before surgery. Cesarean section was successfully performed with spinal anesthesia. A 1566 g male infant was delivered with 1 and 5 min Apgar scores of 2 and 1. Hyperglycemia and secondary hypoglycemia occurred in the infant in the neonatal ICU. The mother's fluid loss, including blood and amniotic fluid, was estimated at 784 ml. Five hundred milliliters of acetated Ringer's solution and 1000 ml of half saline solution with 2.5% glucose were infused before delivery, followed by the glucose solution containing a low concentration of sodium after delivery. After surgery, high serum osmotic pressure and paradoxically low urinary osmotic pressure were found. The plasma antidiuretic hormone level was normal against the high serum osmotic pressure. The electrolyte imbalance and urinary osmotic pressure were improved by using I-deamino-8-d-arginine vasopressin, and DI was finally diagnosed. Hormonal therapy was discontinued on day 20, and the patient was discharged on day 21. Some pregnancies are complicated by transient DI. Anesthesiologists have to consider DI when a pregnant female has symptoms of dehydration and a significant electrolyte imbalance.

Authors+Show Affiliations

Department of Anesthesia, Kumamoto City Hospital, Kumamoto 862-8505.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

12649872

Citation

Amano, Asako, et al. "[Anesthesia for Cesarean Section in a Patient With Transient Diabetes Insipidus]." Masui. the Japanese Journal of Anesthesiology, vol. 52, no. 2, 2003, pp. 158-61.
Amano A, Mitsuse T, Hashiguchi A, et al. [Anesthesia for cesarean section in a patient with transient diabetes insipidus]. Masui. 2003;52(2):158-61.
Amano, A., Mitsuse, T., Hashiguchi, A., Masuda, K., Jo, Y., Akasaka, T., Ogata, S., & Sato, T. (2003). [Anesthesia for cesarean section in a patient with transient diabetes insipidus]. Masui. the Japanese Journal of Anesthesiology, 52(2), 158-61.
Amano A, et al. [Anesthesia for Cesarean Section in a Patient With Transient Diabetes Insipidus]. Masui. 2003;52(2):158-61. PubMed PMID: 12649872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Anesthesia for cesarean section in a patient with transient diabetes insipidus]. AU - Amano,Asako, AU - Mitsuse,Tetsuro, AU - Hashiguchi,Akira, AU - Masuda,Kazuyuki, AU - Jo,Yoshitaka, AU - Akasaka,Takefumi, AU - Ogata,Shinya, AU - Sato,Toshihide, PY - 2003/3/26/pubmed PY - 2003/4/24/medline PY - 2003/3/26/entrez SP - 158 EP - 61 JF - Masui. The Japanese journal of anesthesiology JO - Masui VL - 52 IS - 2 N2 - A 32-year-old pregnant female was admitted to our hospital at 32 week gestation and was scheduled for emergent cesarean section because of fetal distress. She had been suffering hydrodipsia and dry mouth, and had lost 4 kg in 2 weeks. Hypernatremia, hyperchloremia, and lower urinary specific gravity were preoperatively noted. Her electrolyte imbalance was partially corrected by the infusion of 1400 ml of 5% glucose solution and 500 ml of acetated Ringer's solution, but unexpected hyperglycemia; 440 mg.dl-1, appeared before surgery. Cesarean section was successfully performed with spinal anesthesia. A 1566 g male infant was delivered with 1 and 5 min Apgar scores of 2 and 1. Hyperglycemia and secondary hypoglycemia occurred in the infant in the neonatal ICU. The mother's fluid loss, including blood and amniotic fluid, was estimated at 784 ml. Five hundred milliliters of acetated Ringer's solution and 1000 ml of half saline solution with 2.5% glucose were infused before delivery, followed by the glucose solution containing a low concentration of sodium after delivery. After surgery, high serum osmotic pressure and paradoxically low urinary osmotic pressure were found. The plasma antidiuretic hormone level was normal against the high serum osmotic pressure. The electrolyte imbalance and urinary osmotic pressure were improved by using I-deamino-8-d-arginine vasopressin, and DI was finally diagnosed. Hormonal therapy was discontinued on day 20, and the patient was discharged on day 21. Some pregnancies are complicated by transient DI. Anesthesiologists have to consider DI when a pregnant female has symptoms of dehydration and a significant electrolyte imbalance. SN - 0021-4892 UR - https://www.unboundmedicine.com/medline/citation/12649872/[Anesthesia_for_cesarean_section_in_a_patient_with_transient_diabetes_insipidus]_ L2 - https://www.medicalonline.jp/meteo_linkout.php?issn=0021-4892&volume=52&issue=2&spage=158 DB - PRIME DP - Unbound Medicine ER -