Preeclampsia and low sodium: A retrospective cohort analysis and literature review.
Hypertension in pregnancy
Hyponatremia
Management
Preeclampsia
Pregnancy complication
Journal
Pregnancy hypertension
ISSN: 2210-7797
Titre abrégé: Pregnancy Hypertens
Pays: Netherlands
ID NLM: 101552483
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
04
05
2020
revised:
18
12
2020
accepted:
26
12
2020
pubmed:
10
1
2021
medline:
25
9
2021
entrez:
9
1
2021
Statut:
ppublish
Résumé
The aim of this study was to retrospectively analyze the prevalence of severe preeclampsia and low sodium (PALS) among the pregnant population admitted at the University Hospital of Udine in the past 4 years and to compare these data with the current literature. Only women with a diagnosis of preeclampsia were included. According to the lowest sodium level measured either 5 days before or 5 days after delivery, patients were divided in two groups: women with hyponatremia (<135 mmol/L; severe <120 mmol/L) and women with normonatremia (>135 mmol/L). Moreover, a search literature was performed. Of 59 patients with preeclampsia, 20 (34%) had hyponatremia. Only one case (1.6%) of severe maternal hyponatremia (sodium level 117 mmol/L) in the setting of preeclampsia was identified. After literature search, a total of 22 manuscripts including 60 case reports of PALS were identified. The lowest sodium level was 113 mmol/L, at 25 weeks of gestation. In most cases hyponatremia was treated with fluid restriction. In only 5 cases hyponatremia was treated with a saline hypertonic solution. Hyponatremia resolution, when reported, occurred in about 48 h. Sodium level in neonates ranged from 118 and 128 mmol/L. PALS may occur in about a third of women with severe preeclampsia. Severe maternal hyponatremia should be treated with fluid restriction and with hypertonic saline solution. Moreover neonatologists should be alerted in order to treat the neonate for the best outcome.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to retrospectively analyze the prevalence of severe preeclampsia and low sodium (PALS) among the pregnant population admitted at the University Hospital of Udine in the past 4 years and to compare these data with the current literature.
METHODS
METHODS
Only women with a diagnosis of preeclampsia were included. According to the lowest sodium level measured either 5 days before or 5 days after delivery, patients were divided in two groups: women with hyponatremia (<135 mmol/L; severe <120 mmol/L) and women with normonatremia (>135 mmol/L). Moreover, a search literature was performed.
RESULTS
RESULTS
Of 59 patients with preeclampsia, 20 (34%) had hyponatremia. Only one case (1.6%) of severe maternal hyponatremia (sodium level 117 mmol/L) in the setting of preeclampsia was identified. After literature search, a total of 22 manuscripts including 60 case reports of PALS were identified. The lowest sodium level was 113 mmol/L, at 25 weeks of gestation. In most cases hyponatremia was treated with fluid restriction. In only 5 cases hyponatremia was treated with a saline hypertonic solution. Hyponatremia resolution, when reported, occurred in about 48 h. Sodium level in neonates ranged from 118 and 128 mmol/L.
CONCLUSIONS
CONCLUSIONS
PALS may occur in about a third of women with severe preeclampsia. Severe maternal hyponatremia should be treated with fluid restriction and with hypertonic saline solution. Moreover neonatologists should be alerted in order to treat the neonate for the best outcome.
Identifiants
pubmed: 33421847
pii: S2210-7789(20)30167-7
doi: 10.1016/j.preghy.2020.12.007
pii:
doi:
Substances chimiques
Saline Solution, Hypertonic
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
169-173Informations de copyright
Copyright © 2020 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.