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Syndrome of inappropriate ADH secretion in a woman with preeclampsia.
Int J Obstet Anesth. 2007 Oct; 16(4):360-2.IJ

Abstract

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.

Authors+Show Affiliations

Department of Anaesthesia, St Michael's Hospital, Bristol, UK. hjwilson@doctors.org.ukNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17643289

Citation

Wilson, H J., and L E. Shutt. "Syndrome of Inappropriate ADH Secretion in a Woman With Preeclampsia." International Journal of Obstetric Anesthesia, vol. 16, no. 4, 2007, pp. 360-2.
Wilson HJ, Shutt LE. Syndrome of inappropriate ADH secretion in a woman with preeclampsia. Int J Obstet Anesth. 2007;16(4):360-2.
Wilson, H. J., & Shutt, L. E. (2007). Syndrome of inappropriate ADH secretion in a woman with preeclampsia. International Journal of Obstetric Anesthesia, 16(4), 360-2.
Wilson HJ, Shutt LE. Syndrome of Inappropriate ADH Secretion in a Woman With Preeclampsia. Int J Obstet Anesth. 2007;16(4):360-2. PubMed PMID: 17643289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Syndrome of inappropriate ADH secretion in a woman with preeclampsia. AU - Wilson,H J, AU - Shutt,L E, Y1 - 2007/07/20/ PY - 2006/08/01/received PY - 2006/10/01/revised PY - 2007/02/01/accepted PY - 2007/7/24/pubmed PY - 2008/1/1/medline PY - 2007/7/24/entrez SP - 360 EP - 2 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 16 IS - 4 N2 - 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. SN - 0959-289X UR - https://www.unboundmedicine.com/medline/citation/17643289/Syndrome_of_inappropriate_ADH_secretion_in_a_woman_with_preeclampsia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(07)00022-2 DB - PRIME DP - Unbound Medicine ER -