Clinical Case Database / Category: Patient Management
Postpartum seizure as a result of dilutional hyponatraemia during labour
Publication details
Mr David D’Souza, MB, ChB (Birm), MRCOG,, Dr Oliver Meller-Herbert, BSc(Hons), MSc, MB ChB
Foundation Years Journal, volume 8, issue 7, p.62 (123Doc Education, London, July 2014)
Abstract
Although the aetiology of postpartum seizures is diverse, dilutional hyponatraemia is an extremely rare occurrence not often considered by clinicians (1). We present such a case linked to possible excessive fluid intake during labour in an otherwise uncomplicated pregnancy with no significant past medical history.
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Authors
Mr David D’Souza, MB, ChB (Birm), MRCOG,
Consultant and Honorary Associate Professor of Obstetrics & Gynaecology,
South Warwickshire Foundation Trust, Lakin Road, Warwick, CV34 5BW
david.d'souza@swft.nhs.uk
Dr Oliver Meller-Herbert, BSc(Hons), MSc, MB ChB
Foundation Year 1 Doctor,
Barking, Havering & Redbridge University Hospitals
ollymel@yahoo.com
References
1. Jellema J, Balt J, Broeze K, Scheele F, Weimer M. Hyponatraemia during pregnancy. The Internet Journal of Gynecology and Obstetrics 2009; 12(1).
2. Asaeda G, Ferreira R, Pierre-Louis A. Uncommon seizures: eclampsia in the postpartum patient. Journal of Emergency Medical Services 2005; 30(2): 36-8.
3. Small KR, Cannava M, Casey S, Jacques J. Tonic-clonic seizures in a postpartum patient: case report. American Journal of Critical Care 2010; 19(3): 307-5.
4. Brunton PJ, Arunachalam S, Russel JA. Control of neurohypophysial hormone secretion, blood osmolality and volume in pregnancy. Journal of Physiology and Pharmacology 2008; 59 supplement 8:27-45.
5. Lindheimer MD, Davison JM. Osmoregulation, the secretion of arginine vasopressin and its metabolism during pregnancy. European Journal of Endocrinology 2007; 132 (2): 133-43
6. Reeves W, Bichet DG, Andreoli TE. Posterior pituitary and water metabolism. In: Wilson JD, Foster DW, Kronenberg HM, Reed Larsen P, editors, Williams Textbook of Endocrinology 9th Edition. Philadelphia. W.B. Saunders Company 1998: pp 350.
7. Rosner MH, Kirven J. Exercise-associated hyponatremia. Clinical Journal of The American Society of Nephrology: CJASN 2007; 2(1): 151-61.
8. Almond CS, Shin AY, Fortescue EB, Mannix RC, Wypij D, Binstadt BA et al. Hyponatremia among runners in the Boston Marathon. New England Journal of Medicine 2005; 352(15): 1556-6.
9. Moen V, Brudin L, Rundgren M, Irestedt L. Hyponatremia complicating labour - rare or unrecognised? A propsective observational study. BJOG: An International Journal of Obstetrics and Gynaecology 2009; 116 (4) 552-61.
10. National Institute for Health and Clinical Excellence. 2007. Intrapartum care: care of healthy women and their babies during childbirth London, RCOG Press 2007.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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