A Case Report of Preeclampsia Causing Severe Hyponatremia: Rare or Rarely Reported?

Abstract

Preeclampsia presenting as severe hyponatremia is an enigma of modern obstetric practice. The hyponatremia can cause severe maternal neurological morbidity, including cerebral edema and seizures. Neonates, with serum sodium reflecting maternal levels, are also at risk. Despite this, the literature remains ambiguous about its incidence, the pathophysiology is poorly understood, and guidelines on preeclampsia (including those of the American College of Obstetricians and Gynecologists) do not discuss the issue. This case of preeclampsia associated with severe hyponatremia in a laboring woman highlights these issues.

Hyponatraemia compounding pre-eclamptic toxaemia in a patient with type 1 diabetes

“…Previously reported cases have proposed that a dysfunctional placental unit and altered hormone profile in pre-eclampsia can lead to an SIADH-like syndrome. 9 The pathological immune response to placental insufficiency has been associated with a reduction in circulating plasma volume, which is a stimulus for ADH release. 31 It has been postulated that there is an alteration in vasopressinase activity and increase in receptor sensitivity in the pre-eclamptic placenta.…”