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Overconsumption of fluids during labour leading to water intoxication and a tonic–clonic seizure in a healthy labourer
  1. Yogita Shanmugharaj1,
  2. Viktorie Schut1,
  3. Rifat Syed2 and
  4. Anahit Zakaryan2
  1. 1GKT School of Medical Education, King's College London Faculty of Life Sciences and Medicine, London, UK
  2. 2Department of Obstetrics and Gynaecology, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK
  1. Correspondence to Yogita Shanmugharaj; yogita.shanmugharaj{at}kcl.ac.uk

Abstract

A 33-year-old woman in her first pregnancy with no significant medical history had a tonic–clonic seizure one hour after delivery due to acute hyponatraemia caused by excess intake of fluids. She was admitted to a birthing centre as a low-risk labourer where she spent 19 hours including 4 hours in the second stage of labour. Throughout the labour, she was encouraged to drink as per her own initiative and thirst. However, there was no monitoring of fluid intake. In spite of initial confusion about the cause of the seizure, a multidisciplinary approach helped with diagnosis of an underlying pathology and allowed timely treatment to avoid adverse outcomes in this patient. We would like to increase awareness of a possibility, however rare, of water intoxication due to fluid overconsumption by patients in labour and encourage production of information guidance for monitoring of fluid intake of women in labour.

  • obstetrics and gynaecology
  • pregnancy

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Footnotes

  • Contributors YS and VS worked on the manuscript together after speaking to RS about the clinical case that occurred. They conducted research in order to write up the manuscript, under the supervision of RS and AZ. RS presented the case at the departmental meeting. She looked through the final draft and verified the clinical aspects of the case report. AZ acted as a supervisor and oversaw the whole process. She helped with editing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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