Severe maternal and neonatal hyponatraemia following excessive oral fluid intake during labour
Year: 2026
Type: article
Study design: Case Report
Abstract: Peripartum hyponatraemia is an under-recognised but potentially serious complication of pregnancy. We report a primigravid woman at 41 weeks gestation who developed severe acute-on-chronic hypo-osmolar hyponatraemia (111 mmol/L; osmolality 256 mOsm/kg) after drinking approximately 6 L of water during labour, without synthetic oxytocin nor hypotonic intravenous fluids during labour. Early maternal neurological symptoms were initially misattributed to labour. The diagnosis was only recognised after the newborn had a generalised seizure 3 hours after birth and was found to have hyponatraemia (118 mmol/L; osmolality 243 mOsm/kg). After delivery, maternal rapid spontaneous natraemia correction because of water restriction required treatment with desmopressin and 5% dextrose to prevent overcorrection. Both mother and neonate recovered without neurological sequelae. This case highlights that excessive oral water intake alone may cause severe maternal and neonatal hyponatraemia, and underscores the importance of fluid balance monitoring, rapid electrolyte testing and coordinated multidisciplinary management.
Source: BMJ Case Reports
Institution: University Hospital of Geneva
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7223668663