Severe maternal and neonatal hyponatraemia following excessive oral fluid intake during labour
- 1Department of Woman, Child and Adolescent, Geneva University Hospitals Maternity Hospital, Geneva, GE, Switzerland
- 2Department of Nephrology and Hypertension, Geneva University Hospitals Department of Medical Specializations, Geneva, GE, Switzerland
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.
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BibTeX
@article{preux2026severe,
title = {{Severe maternal and neonatal hyponatraemia following excessive oral fluid intake during labour}},
author = {Marie De Preux and Julia Michel and Léa Audrey Roth and Laura Gabriel and David A Jaques and Océane Pécheux and Caroline Daelemans},
journal = {BMJ Case Reports},
year = {2026},
month = oct,
doi = {10.1136/bcr-2026-273881},
url = {https://doi.org/10.1136/bcr-2026-273881},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Severe maternal and neonatal hyponatraemia following excessive oral fluid intake during labour
AU - Marie De Preux
AU - Julia Michel
AU - Léa Audrey Roth
AU - Laura Gabriel
AU - David A Jaques
AU - Océane Pécheux
AU - Caroline Daelemans
PY - 2026
DA - 2026/10/26
JO - BMJ Case Reports
DO - 10.1136/bcr-2026-273881
UR - https://doi.org/10.1136/bcr-2026-273881
AB - 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.
SN - 1757-790X
ER -