Pre-eclampsia complicated by severe hyponatraemia.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Endocrinology

Background:

• Pre-eclampsia is a common pregnancy complication characterized by high blood pressure.
• Hyponatraemia, or low sodium levels, is an uncommon but serious complication of pre-eclampsia.
• Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) can cause hyponatraemia.

Observation:

• A 41-year-old woman at 35 weeks gestation with pre-eclampsia developed severe hyponatraemia (125 mmol/L).
• The hyponatraemia was attributed to SIADH.
• Initial management included fluid restriction, but fetal distress necessitated an emergency caesarean section.

Findings:

• Maternal sodium levels normalized within 48 hours postpartum.
• Low maternal sodium levels increase seizure risk in pre-eclampsia.
• Fetal sodium levels equilibrate with maternal levels, potentially causing adverse effects like tachycardia, jaundice, and polyhydramnios.

Implications:

• This case underscores the critical need for vigilant electrolyte monitoring in pre-eclampsia.
• Severe hyponatraemia in pre-eclampsia may necessitate urgent delivery due to maternal and fetal risks.
• Understanding the link between pre-eclampsia, SIADH, and hyponatraemia is crucial for optimal patient management.