medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2013, Number 4

<< Back Next >>

An Med Asoc Med Hosp ABC 2013; 58 (4)

Hypoosmolar hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion in the immediate postpartum after using oxytocin

Hugues GMG, Álvarez LAA, Hernández JA, García LJF

Language: Spanish
References: 16
Page: 267-271
PDF size: 350.66 Kb.


ABSTRACT

The syndrome of inappropriate antidiuretic hormone secretion is a disorder in which water secretion is partially affected because of the body’s inability to adequately suppress the secretion of antidiuretic hormone; this retention leads to hyponatremia. The resemblance between oxytocin and the antidiuretic hormone can make the former have similar effects to the latter when using it at high doses (more than 15 mU/minute) during labor conduction , causing acute retention of urine and, therefore, dilutional hyponatremia. We present an atypical case of the syndrome of inappropriate antidiuretic hormone secretion associated with the administration of low dosages of oxytocin during labor conduction through a short period of time (6 mU/min during 3 hours). The conduction of labor with oxytocin is a common practice in obstetric services. High dosages of this hormone may produce acute water intoxication and dilutional hyponatremia, because of the similarity of its structure with that of the antidiuretic hormone, presenting itself with unspecific neurological alterations.


REFERENCES

  1. Hayes EJ, Weinstein L. Improving patient safety and uniformity of care by a standardized regimen for the use of oxytocin. Am J Obstet Gynecol. 2008; 198: 622.

  2. Porreco RP, Clark SL, Belfort MA, Dildy GA, Meyers JA. The changing specter of uterine rupture. Am J Obstet Gynecol. 2009; 200: 269.

  3. Kramer MS, Rouleau J, Baskett TF, Joseph KS. Amniotic-fluid embolism and medical induction of labour: A retrospective, population-based cohort study. Lancet. 2006; 368: 1444.

  4. Lindheimer MD, Barron WM, Davison JM. Osmoregulation of thirst and vasopressin release in pregnancy. Am J Physiol. 1989; 257: 159.

  5. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders. 5th ed. New York: McGraw-Hill; 2001. p. 699-716.

  6. Ellison D, Berl T. The syndrome of inappropriate antidiuresis. NEJM. 2007; 356: 2064-2072.

  7. Paidas, MJ, Ku DH Arkel YS. Screening and management of inherited trombophilias in the setting of adverse pregnancy outcome. Clin Perinatol. 2204; 31: 783.

  8. Ku DH, Argel YS, Paidas MJ, Lozwood CJ. Circulating levels of inflammatory cytokynes (IL-1b and TNF alfa), Resistance to activated protein C, thrombin and fibrin generation in uncomplicated pregnancies. Thromb Haemost. 2003; 90: 1074.

  9. Caplan LR. Transient ischemic attack: Definition and natural history. Curr Atheroscler Rep. 2006; 8: 276.

  10. Brunton LL, Lazo JS, Parker KL. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 11th ed. New York: McGraw-Hill; 2007. p. 977-979.

  11. Cunningham F, Leveno L, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetricia. 23rd ed. New York: McGraw-Hill; 2011. p. 505-508.

  12. Ophir E, Solt I, Odeh M, Bornstein J. Water intoxication a dangerous condition in labor and delivery rooms. Obstet Gynecol Surv. 2007; 62 (11): 731-738.

  13. De Fronzo RA, Arieff AI. Hyponatremia. In: Arieff AI, De Fronzo RA (eds). Fluid, Electrolyte and Acid-Base Disorders. New York: Churchill Livingstone; 1995. p. 255-303.

  14. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders. 5th ed. New York: McGraw-Hill; 2001. p. 703-711.

  15. Whalley PJ, Pritchard JA. Oxytocin and water intoxication. JAMA. 1963; 186: 601.

  16. Feeney JG. Water intoxication and oxytocin. Br Med J (Clin Res Ed). 1982; 285: 243.




2020     |     www.medigraphic.com