title: Approach to the diagnosis and treatment of hyponatremia in pregnancy.
abstract: Hyponatremia is the most commonly encountered electrolyte abnormality. Severe hyponatremia in pregnancy poses diagnostic and therapeutic challenges. Pregnancy involves changes in physiology that affect water and sodium homeostasis. Knowledge of these complex physiologic alterations during pregnancy is critical to managing dysnatremias in pregnancy. This teaching case describes a woman with chronic hyponatremia who presented during pregnancy with worsening hyponatremia. She had an activating vasopressin receptor mutation, which was passed on to her child, and her diagnostic workup is described.
authors.affiliation: Section of Nephrology, Yale University School of Medicine, New Haven, CT.
authors.forename: George S
authors.initials: GS
authors.lastname: Pazhayattil
authors.affiliation: Section of Nephrology, Yale University School of Medicine, New Haven, CT.
authors.forename: Asghar
authors.initials: A
authors.lastname: Rastegar
authors.affiliation: Section of Nephrology, Yale University School of Medicine, New Haven, CT. Electronic address: ursula.brewster@yale.edu.
authors.forename: Ursula C
authors.initials: UC
authors.lastname: Brewster
mesh_terms: D000328:Adult; D005260:Female; D005440:Fluid Therapy; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D009154:Mutation / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D017483:Receptors, Vasopressin / Q000235:genetics; D012964:Sodium / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D017483:Receptors, Vasopressin; D012964:Sodium
keywords: Hyponatremia; R137C; arginine vasopressin receptor 2 (AVPR2); euvolemic hypotonic hyponatremia; pregnancy; sodium; syndrome of inappropriate antidiuretic hormone secretion (SIADH); vasopressin receptor