Preeclampsia Complicated by Hyponatremia

0. Akinro, A. Hemaid, A. Van Der Meer

Case Report:

A 31-year-old nulliparous woman presented at 34 weeks of gestation with reduced fetal movements. The patient’s pregnancy and medical history had been uneventful. She had severe hypertension and proteinuria but no signs of imminent eclampsia. She required labetalol and nifedipine for blood pressure control. Investigations confirmed mild Hyponatremia 128mmol/l and urinary Protein: Creatinine ratio 1034.5 mg/mmol (nephrotic range). The patient received steroids for fetal optimisation. A multidisciplinary review was performed, and the medical team advised fluid restriction of 30mls/hr. Fetal ultrasound confirmed intrauterine growth restriction (7th centile) with oligohydramnios and normal dopplers. Despite fluid restriction, the hyponatremia worsened to severe (122 mmol/l). The patient was counselled regarding the recommendation to expedite delivery. She had an uncomplicated caesarean section 36 hours after admission.