Severe hypernatremia after cesarean delivery secondary to transient diabetes insipidus of pregnancy

Sherer, David M.; Cutler, J. W.; Santoso, Paulus; Angus, Sandra; Abulafia, Ovadia

doi:10.1016/s0029-7844(03)00704-x

Cited by 10 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diabetes insipidus, for example, is a disorder characterized by the manifestation of polyuria and polydipsia. It can occur transiently during pregnancy, and is associated with acute fatty liver, pre‐eclampsia, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, and multiple pregnancies (Sherer et al, ). Profound hypernatremia (electrolyte disturbance associated with increased sodium concentration in the blood) is a typical manifestation of diabetes insipidus, which can lead to the development of congenital holoprosencephaly (Vaqar et al, ), resulting in the failure of normal prosencephalon formation and thus the absence of two cerebral hemispheres.…”

Section: Introductionmentioning

confidence: 99%

“…Anisotonic osmolarity can be transmitted from the mother to the fetus as its manifestation can depend on the volume and hypotonicity of maternal plasma. Chronic hypertonicity, on the other hand, would induce a directed fetal‐to‐maternal flow of water that causes oligohydramnios, which in turn affects fetal development and survival (Sherer et al, ). Indeed, post‐term rats posses abnormal water transfer, presumably due to anisotonic conditions in utero, while infants with hydranencephaly and chronic hypernatremia possess a disrupted thirst response and anti‐diuretic hormone (ADH) secretion (Endo et al, ), which markedly elevates their plasma osmolarity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

et al. 2015

View full text Add to dashboard Cite

Many maternal disorders that modify the embryonic microenvironment, such as a change in osmolarity, can affect development, but how these changes influence the early embryo remains obscure. Neural tube defects, for example, are common congenital disorders found in fetus and neonates. In this study, we investigated the impact of anisotonic osmolarity (unequal osmotic pressures) on neural tube development in the early chick embryo, finding that neuronal cell differentiation was impaired in the neural tube due to enhanced apoptosis and repressed cell proliferation. Anisotonic osmolarity also affected normal development of the neural crest, which in turn influenced abnormal development of the neural tube. As neural tube development is highly dependent on the proper expression of bone morphogenetic protein 4 (BMP4), paired box 7 (PAX7), and sonic hedgehog (SHH) genes in the dorsal and ventral regions along the tube, we investigated the impact of anisotonic osmolarity on their expression. Indeed, small changes in osmolarity could positively and negatively impact the expression of these regulatory genes, which profoundly affected neural tube development. Thus, both the central and peripheral nervous systems were perturbed by anisotonic consitions as a consequence of the abnormal expression of key genes within the developing neural tube.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

et al. 2015

View full text Add to dashboard Cite

show abstract

“…[9] A woman with gestational diabetes insipidus (GDI) manifesting in the later third trimester had encephalopathy with hypernatremia following cesarean section. [10] Recurrent GDI was reported in a patient with hemochromatosis who had low ADH levels with increased vasopressinase levels probably due to reduced hepatic breakdown of vasopressinase. [11] If aminopeptidase activity does not reduce following delivery, it could produce deficiency of ADH resulting in diabetes insipidus and can explain the hypernatremia in the postpartum state.…”

Section: Discussionmentioning

confidence: 99%

′Wine Glass′ sign in recurrent postpartum hypernatremic osmotic cerebral demyelination

Saroja

Naik

Mali

et al. 2013

Ann Indian Acad Neurol

View full text Add to dashboard Cite

Osmotic demyelination syndrome resulting from postpartum hypernatremia is a recently described entity wherein young women present with hypernatremic encephalopathy and white matter hyperintensities along with quadriparesis from rhabdomyolysis. It is an acute monophasic condition with acute hypernatremia occurring during puerperium with good recovery in majority of the patients with treatment. To the best of our knowledge, recurrent postpartum hypernatremia with encephalopathy, osmotic demyelination, and rhabdomyolysis has not been described. We present a young lady who had two episodes of reversible postpartum hypernatremic encephalopathy with rhabdomyolysis. Cerebral magnetic resonance imaging (MRI) before treatment revealed osmotic demyelination on both occasions. During first admission MRI revealed hyperintensities in internal capsule and corpus callosum, and at second admission revealed more extensive white matter hyperintensity, which simulated the ‘wine glass’ appearance.

show abstract

“…It can occur in postpartum period especially if fluid intake of the patient is restricted which can result in severe hypernatremia (Sherer et al, 2003). It commonly occurs in women with multiple gestations due to higher placental volume and hence increased vasopressinase level.…”

Section: Preeclampsia Superimposed On Chronic Hypertensionmentioning

confidence: 99%

Gynaecologic Nephrology

R.¹

2012

American Medical Journal

View full text Add to dashboard Cite

Renal issues are commonly encountered in females. They can occur both in pregnant and nonpregnant females. Many physiologic changes occur during pregnancy to accommodate the growing fetus. Pregnancy is characterized by changes in blood pressure and expansion of total body volume which results in high glomerular filtration rate. The common renal problems seen in pregnant females are hypertension, proteinuria with or without nephrotic syndrome, acute kidney injury. It is not uncommon to see a pregnant female who may have pre-existing chronic kidney disease. A very few women receiving dialysis become pregnant. Renal transplantation restores the infertility seen in chronic kidney disease. Renal transplant recipients with pregnancy require very close monitoring of immunosuppressive medications to prevent acute rejection due to altered drug absorption and metabolism in pregnancy. Uterine fibroids are commonly encounters in women of reproductive age. Nonpregnant females with uterine fibroids usually experience non-renal symptoms like excessive uterine bleeding but few of them can develop hypertension, acute kidney injury and chronic kidney disease from uterine fibroids. Malignancies of female genital system can give rise to kidney failure when locally invasive. This review paper gives details of various renal problems seen by nephrologists in female patients both during pregnancy and nonpregnant states in daily practice.

show abstract

Severe hypernatremia after cesarean delivery secondary to transient diabetes insipidus of pregnancy

Abstract: Transient diabetes insipidus of pregnancy should be considered in the differential diagnosis of severe hypernatremia in obstetric patients with restricted oral intake after operative delivery.

Cited by 10 publications

References 10 publications

Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

′Wine Glass′ sign in recurrent postpartum hypernatremic osmotic cerebral demyelination

Gynaecologic Nephrology

Contact Info

Product

Resources

About

Severe hypernatremia after cesarean delivery secondary to transient diabetes insipidus of pregnancy

Abstract: Transient diabetes insipidus of pregnancy should be considered in the differential diagnosis of severe hypernatremia in obstetric patients with restricted oral intake after operative delivery.

Cited by 10 publications

References 10 publications

­Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

­Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

′Wine Glass′ sign in recurrent postpartum hypernatremic osmotic cerebral demyelination

Gynaecologic Nephrology

Contact Info

Product

Resources

About

Changes in the osmolarity of the embryonic microenvironment induce neural tube defects

Changes in the osmolarity of the embryonic microenvironment induce neural tube defects