Abstract
A 42-year-old high risk pregnant female presented with hyponatremia from multiple causes and was treated with total parenteral nutrition. She developed acute hypernatremia due to the stage of pregnancy and other comorbidities. All the mechanisms of hyponatremia and hypernatremia were summarized here in our case report. This case has picture (graph) representation of parameters that led to changes in serum sodium and radiological findings of central pontine myelinolysis on MRI. In conclusion we present a complicated case serum sodium changes during pregnancy and pathophysiological effects on serum sodium changes during pregnancy.
Highlights
Hyponatremia is defined as a sodium concentration less than 135 mEq/L
Hyponatremia that was caused by hypovolemia and low osmotic intake in the setting of hyperemesis gravidarum (HG) was treated with hydration, protein supplementation, and nausea control
This case report describes the occurrence of rapid overcorrection of hyponatremia in pregnancy and sepsis
Summary
Hyponatremia is defined as a sodium concentration less than 135 mEq/L. If hyponatremia is not corrected appropriately, it can lead to significant clinical symptoms. The osmotic threshold is decreased to a lower steady state value due to excess ADH release and a heightened thirst stimulus This results in a decrease in the average plasma-osmolality by 5–10 mmol and the sodium concentration by up to 5 mmol/L [1]. HG is a complication of pregnancy that is associated with assisted reproduction techniques and multiple gestations [2, 3] It is characterized by intractable vomiting often requiring parenteral nutrition and can have a profound effect on the patient’s fluid and electrolyte status. It can result in malnutrition, hyponatremia, and low serum urea levels [4, 5]. T2-weighted diffusion image showing the classic trident-shaped pontine hyperintense signal
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