An Unforgotten Cause of Acute Hyponatremia: Water Intoxication due to Oxytocin Administration in a Pregnant Woman

Wang, Jenn Yeu; Lin, Shih Hua; Lin, Yuh Feng; Chen, Hui Yen; Yu, Fei; Fu, Mao

doi:10.1159/000045791

Cited by 13 publications

(10 citation statements)

References 4 publications

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“…Acute water intoxication as a result of oxytoxin infusion should be in the differential diagnosis of obstetrical patients with convulsions (17). This complication is usually hospital-acquired but may be encountered in the ED.…”

Section: Discussionmentioning

confidence: 99%

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Biochemical and etiological characteristics of acute hyponatremia in the emergency department

Hsu¹,

Chiu²,

Lu³

et al. 2005

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

“…Three hours after the procedure, she was transferred to our ED due to a grand mal seizure and loss of consciousness. In addition to stimulating uterine contractions, oxytoxin has an ADH-like effect and acute hyponatremia can be prevented by restriction of EFW and adequate administration of isotonic saline (17).…”

Section: Discussionmentioning

confidence: 99%

Biochemical and etiological characteristics of acute hyponatremia in the emergency department

Hsu¹,

Chiu²,

Lu³

et al. 2005

The Journal of Emergency Medicine

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“…It is likely that in the future these agents will prove useful in treating symptomatic hyponatremia occurring during pregnancy and labor, because those conditions are caused by increased ADH levels. In all cases of hyponatremia, close and frequent monitoring of serum [Na ϩ ] and neurologic symptoms every 2 hours during labor is mandatory (32,61).…”

Section: Treatmentmentioning

confidence: 99%

“…5. Water intoxication should be considered in the differential diagnosis of obstetrical patients with convulsions or coma (61).…”

Section: Pregnant Women Should Receive Informationmentioning

confidence: 99%

Water Intoxication—A Dangerous Condition in Labor and Delivery Rooms

Ophir¹,

Solt²,

Odeh³

et al. 2007

Obstetrical &Amp; Gynecological Survey

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Water intoxication, a form of acute hyponatremia, has been described in various clinical situations. Although hyponatremia is a common metabolic disorder in hospitalized patients, it is generally not well known as a hazard in the labor and delivery room. However, several factors predispose laboring women to develop hyponatremia. Moreover, because the fetus acquires water from the maternal circulation via the placenta, and there is a close correlation between maternal and cord blood serum sodium levels, the newborn infant of a hyponatremic mother is also at considerable risk of developing water intoxication. We review the epidemiology, pathophysiology, clinical features, and treatment of this hazardous disorder. We emphasize the need for awareness of this condition, and call attention to the risk of fluid overload during labor.

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“…; Wang et al. ). The affinity of oxytocin to the V2 receptor is, however, much lower than that of vasopressin (Joo et al.…”

Section: Introductionmentioning

confidence: 98%

Oral Contraceptives and Renal Water Handling

et al. 2017

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To test the hypothesis that use of oral contraceptives (OC) changes diurnal variation in fluid balance mechanisms including blood pressure, secretion of vasopressin and oxytocin, and renal water and electrolyte excretion. Fifteen naturally cycling (NC) women in mid‐follicular phase and 11 long‐term OC users were included in a 24‐h standardized inpatient study for measurements of vasopressin, oxytocin, sodium, and osmolality in plasma as well as urinary excretion of electrolytes, aquaporin‐2, and prostaglandin E2. Blood pressure and heart rate were monitored noninvasively. Plasma vasopressin showed circadian rhythm (P = 0.02) and were similar in both groups (P = 0.18) including nighttime increases (P < 0.001). There was no circadian rhythm in plasma oxytocin within (P = 0.84) or between groups (P = 0.22). OC users had significantly lower plasma osmolality (Δosm: 3.05 ± 0.29 mosm/kg, P = 0.04) and lower plasma sodium (ΔNa+: 0.91 ± 0.09 mmol/l, P = 0.05). The two groups showed similar nighttime decreases in diuresis (1.08 ± 0.04 mL/(kg·h), P < 0.001) and increases in urine osmolality (109 ± 9 mosm/kg, P = 0.02), but similar rates of excretion of Aquaporin‐2, prostaglandin E2 and sodium. Nighttime decreases in mean arterial pressure of approximately 13% were significant in both groups (P < 0.001), but 24‐h average mean arterial pressure was significantly higher in OC users than in controls (+4.7 ± 0.4 mmHg, P = 0.02). Packed cell volumes were similar between groups (P = 0.54). OC does not change the diurnal patterns of renal fluid excretion, but resets the osmoreceptors for vasopressin release and leads to a significant increase in arterial blood pressure.

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An Unforgotten Cause of Acute Hyponatremia: Water Intoxication due to Oxytocin Administration in a Pregnant Woman

Cited by 13 publications

References 4 publications

Biochemical and etiological characteristics of acute hyponatremia in the emergency department

Biochemical and etiological characteristics of acute hyponatremia in the emergency department

Water Intoxication—A Dangerous Condition in Labor and Delivery Rooms

Oral Contraceptives and Renal Water Handling

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