Oxytocin Induced Water Intoxication at Mid-trimester Abortion

Abstract

Objective Water intoxication is a rare but serious effect of intravenous synthetic oxytocin in obstetrics, which should not be ignored. Here we present a referred case with generalized seizures due to water intoxication secondary to hyponatremia after receiving intravenous oxytocin in an extremely high dose at a mid-trimester termination. Case Report(s) A 17-year-old female, G1PO, with singleton pregnancy at 18 weeks of gestation, received termination by intravenous oxytocin in a rate over 100 mlU per hour in a 5% dextrose line for sixteen hours, and then developed grand-mal seizure subsequently during abortion at a local clinic. She was immediately transferred to our Hospital with a dead fetus in utero and severe hyponatremia. After hyponatremia was corrected, her consciousness completely recovered without any neurological sequelae. Conclusion(s) We reported this case in order to remind our colleagues the adverse effect of water intoxication when using synthetic oxytocin for induction or termination. To avoid this serious complication by oxytocin, always keep the dose of oxytocin at the lowest effective level. Furthermore, remember to use the sodium-containing intravenous solution, for example, normal saline, or 2.5% dextrose saline, etc. for the intravenous oxytocin infusion.