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

Pu, Yonglin; Wang, Xia; Bu, Hualei; Zhang, Wenzhe; Lu, Ruihui; Zhang, Shuquan

doi:10.1007/s00404-020-05823-9

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…An understanding of these changes, thus, is necessary in order to differentiate it from a pathological disease process. Sodium levels as low as 130 mEq/L may be observed during pregnancy due to a phenomenon known as the “reset osmostat” phenomenon, where an increase in beta human chorionic gonadotropin triggers release of antidiuretic hormone (ADH) sooner than typically [ 13 ]. Despite this, treatment is not required because volume status often remains stable [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike physiologic hyponatremia in normal pregnancy, however, the etiology and mechanism of severe hyponatremia is not clear. It is theorized that this effect may be a result of syndrome of inappropriate antidiuretic hormone (SIADH) or possibly a compounding effect of preeclampsia and induced nephrotic syndrome [ 13 ]. After exclusion of other potential causes of hyponatremia, SIADH can be identified by low serum osmolality and inappropriately elevated urine osmolality and urine sodium concentration [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous studies, the study population was divided into two groups, a minimum sodium level equal to and below 134 mEq/L and a minimum sodium level equal to and above 135 mEq/L [ 13 ]. Severe hyponatremia was evaluated and defined as a level below 120 mEq/L.…”

Section: Methodsmentioning

confidence: 99%

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Impact of hyponatremia in preeclamptic patients with severe features

Endres,

Roberts,

Fang

et al. 2024

PLoS ONE

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Hyponatremia, though common in women with preeclampsia, has not been well studied. Our primary objectives are to assess the clinical characteristics and emergency therapy applied to subjects diagnosed with preeclampsia. We hypothesize that hyponatremia present in preeclamptic patients with severe features is associated with greater use of emergency hypertensives, antenatal steroids, and cesarean delivery. This is a retrospective descriptive study utilizing an electronic health record database (TriNetX ®). We collected and evaluated the following data of subjects aged 15 to 54 years with preeclampsia with severe features diagnosis: demographics, diagnostic codes, medication codes, procedure codes, deaths, and laboratory results. A total of 2,901 subjects [215 (7.4%)] with a sodium level below 134 mEq/L and [2686 (92.6%)] with a sodium level above 135 mEq/L were included. A higher proportion of subjects in the below 134 sodium group received emergency antihypertensives [165 (76.7%) versus 1811 (67.4%), p = 0.01], antenatal steroids [103 (47.9%) versus 953 (35.5%), p = 0.001], and cesarean section [27 (12.6%) versus 97 (3.6%), p = <0.001]. We found that hyponatremia may be associated with emergency antihypertensive use, antenatal steroid use, and cesarean section in patients with preeclampsia with severe features. Future research is needed to determine if routine sodium levels assessed in preeclamptic subjects with severe features identify subjects at risk of receiving these treatments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%