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.
From the *Clinical School, University of Queensland, Toowoomba, Australia
†Royal Brisbane and Women’s Hospital, University of Queensland, Brisbane, Australia
‡Queensland Health, Toowoomba, Australia
§St Vincent’s Hospital Toowoomba, Australia
‖ICU St Vincent’s Hospital Toowoomba, Australia.
Accepted for publication August 27, 2018.
The authors declare no conflicts of interest.
Address correspondence to Wallace Grimmett, MBBS, FANZCA, 5 Campbell St, Toowoomba, QLD 4350, Australia. Address e-mail to firstname.lastname@example.org.