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Preeclampsiainduced Hypernatremia, Hypokalaemia, Hypocalemia and Hypomagnesemia
ISSN: 2376-127X

Journal of Pregnancy and Child Health
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  • Review   
  • JPCH, Vol 10(1)

Preeclampsiainduced Hypernatremia, Hypokalaemia, Hypocalemia and Hypomagnesemia

Shaik Reehana1, Mopidevi.Meghana2 and J. AMOS BABU3*
1Department of pharmacy practise, A.M Reddy Memorial College Of pharmacy, Petlurivaripalem, Narasaraopet, Guntur 522601, Andhra Pradesh, India
2Department of pharmacy practise, A.M Reddy Memorial College Of pharmacy, Petlurivaripalem, Narasaraopet, Guntur 522601, Andhra Pradesh, India
3Department of Pharmacology, A.M Reddy Memorial College Of pharmacy, Petlurivaripalem, Narasaraopet, Guntur 522601, Andhra Pradesh, India
*Corresponding Author: J. AMOS BABU, Department of Pharmacology, A.M Reddy Memorial College Of pharmacy, Petlurivaripalem, Narasaraopet, Guntur 522601, Andhra Pradesh, India

Received: 02-Jan-2023 / Manuscript No. jpch-23-85906 / Editor assigned: 06-Jan-2023 / PreQC No. jpch-23-85906 (PQ) / Reviewed: 20-Jan-2023 / QC No. jpch-23-85906 / Revised: 23-Jan-2023 / Manuscript No. jpch-23-85906 (R) / Accepted Date: 30-Jan-2023 / Published Date: 30-Jan-2023

Abstract

Preeclampsia is hypertensive complication that occur during pregnancy where elevated blood pressure in mother and baby. Generally, it occursduring 3rd trimester of gestational period, it is characterised by vasospasm, vasoconstriction, elevated blood pressure by the increased sensitivity of substances like aldosterone, endothelin, prostaglandinE2, angiotensin-II, TRMP6 genes which causes electrolytes imbalances in maternal body. Conditions like hypernatremia, hypokalaemia, hypomagnesemia, hypocalcaemia are mostly commonly associated with preeclampsia. So, during this therapy potassium, calcium & magnesium are given, while sodium is restricted to minimize further progression of preeclampsia.

Introduction

Usually, hypertensives syndromes that occur during pregnancy, mainly like Preeclampsia, which result in risk for both maternal and child [1]. These syndromes are causal factors related to maternal health and serious problem resulting from associated prematurity [2]. Hypertensive disorders are a common complication of pregnancy that put women and their foetus at disproportionate risk [3]. These hypertensive disorders of pregnancy and in particular preterm preeclampsia is also associated with substantial risk for cardiovascular disease (CVD) and cerebrovascular disease [3]. Normally during gestation hypertension is diagnosed only after 20 weeks of gestation. During the delivery the most of the symptoms are resolved, only certain complication cases the preeclampsia can be persist after delivery also [4]. Preeclampsia induced maternal complications includes increase maternal cardiovascular, Metabolic, cerebrovascular disease premature mortality [5]. Preeclampsia induced neonatal complications includes secondary iatrogenic preterm delivery, increase risk of fetal growth restriction, placenta abruption, respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterolitis, neurodevelopmental delay, fetal or neonatal death [6]. Pathophysiology includes due to poor placentation secondary to abnormal trophoblast invasion and spiral artery remodelling which leads to placental ischemia and leads to activation of maternal immune -mediated response and release of anti-angiogenic factors and leads to angiogenic imbalance, immune mediated exaggerated, inflammatory response, and endothelial cell dysfunction [7]. Pregnant women are prone to high volume losing electrolytes more rapidly [Table 1].

Electrolytes Normal ranges
1st trimester – 1st week – end of 12th week 2nd trimester – 13th week – end of 26th week 3rd trimester – 27th week – end of pregnancy
Sodium 135 – 139 mEq/L 131 – 136 mEq/L 134 - 137 mEq/L
Potassium 3.6 – 5.0 mEq/L 3.3 – 5.0 mEq/L 3.3 – 5.1 mEq/L
Magnesium 1.6 – 2.2 mg/dL 1.5 – 2.2 mg/dL 1.5 – 2.2 mg/dL
Calcium 8.8 – 10.6 mg/dL 8.2 – 9.0 mg/dL 8.2 – 9.7 mg/dL

Table 1: Pregnant women are prone to high volume losing electrolytes more rapidly.

Discussion

Role of sodium, potassium, magnesium &calcium Sodium

1. It maintains a normal balance of fluids and minerals in the body

2. It helps in development of nervous in premature babies

3. Monitoring of sodium intake during severe morning sickness and hyperemesis gravidarum

Potassium

1. It maintains Muscle communication, electrolyte balance, optimal fetal growth

2. It works with sodium to maintain proper fluid balance

3. Foods like sweets potatoes, tomatoes, kidney beans, bananas, dried fruits, yogurt, spinach, broccolishould be included in diet.

Magnesium

1. It maintains proper Mood, sleep, bone health, hydration.

2. It maintains normal blood pressure, protein synthesis, muscle and nerve functions & bone strength in babies

3. It reduces risk of still birth, fetal growth restrictions & preeclampsia.

4. Foods like nuts, seeds, grains, green leafy vegetables and beansshould be included in diet.

Calcium

1. It supports musculoskeletal nervous (teeth and bone development in babies) & circulatory systems (reduces risk of hypertensive disorders, risk of preterm delivery, risk of postpartum haemorrhage)

2. It also maintains normal heart rhythm & blood clotting abilities in babies

3. During 2nd and 3rd trimester the calcium requirement is high

4. Foods like fishes (salmon, sardines), dairy products, leafy vegetables, legumes and seeds should be included in diet.

Mechanism

Hypernatremia induced preeclampsia –water and electrolytes leading to sodium retention and potassium depletion which leads to peripheral vascular resistance hypertension, hypomagnesemia, hypocalcaemia Hypokalaemia induced preeclampsia – during vomiting conditions eliminates acid, and causes metabolic alkalosis, and leads to potassium loss [8]. Hypocalcaemia induced preeclampsia – calcium plays a crucial role in the function of vascular smooth muscles [9]. Alternation of plasma calcium concentration leads increase in Blood pressure [10]. Hypomagnesemia induced preeclampsia – magnesium act as a co-factor of many enzymes NA+, K+ATPase involved in peripheral vasodilation [11]. Ca+, Mg+ which acts relaxants effect on blood vessel of pregnant women [12]. Both magnesium and sodium are known to decrease intracellular calcium which leads to smooth muscle contraction. Leads to elevated blood pressure [Table 2].

Electrolytes imbalance Causes Mechanism
Hypernatremia Water and electrolytes imbalance Increased sensitivity of vasopressor substances like aldosterone decreased cyclic GMP endothelin and PGE2 leads to sodium retention and potassium depletion
Hypokalaemia Vomiting, diarrhoea, excess you use for diuretics Increased sensitivity of aldosterone leads to potassium depletion
Hypocalcaemia Hypoparathyroidism Disrupted calcium homeostasis can lead to altered vasoconstriction and decreased intracellular calcium in smooth muscle cells resulting increased sensitivity of angiotensin-II leads to vasoconstriction and hypertension
Calcium deficiency
Hypomagnesemia Little intake of magnesium Increased sensitivity of TRMP6 at 12 weeks gestation leads to magnesium depletion.
Excessive loss of magnesium through kidneys and gastrointestinal tract
Mutations of TRPM6 genes 

Table 2: Hypernatremia induced preeclampsia.

Pharmacotherapy

(i) Non-pharmacological therapy

1. Regular exercise to be done

2. Drink 5-8 glasses of water daily

3. Eat healthy food (leafy vegetables & fruits

4. Avoid fried foods and junk food

5. Elevate your feet during the day several times

6. Avoid alcohol, caffeine etc.,

Pharmacological therapy

General treatment includes Anti-Hypertensive, Anti-Convulsant & Corticosteroids to patients [13]. Magnesium sulphate which is mostly commonly used in preeclampsia which shows a relaxant effect on umbilical arterial tone leading to vasoconstriction effect on angiotensin-II and endothelin-I in foetal placental vasculature in mother [13]. According to FDA class of drugs like category-A, B, C are given to preeclampsia patients while D & X are avoided drugs [Table 3].

Symptoms Treatment
Increased BP image Hydralazine (increased risk of maternal hypotension)
image Labetalol
image Nicardipine
image Sodium nitroprusside (emergency condition, but cyanide crosses placenta fatal toxicity)
Proteinuria image Eat less protein
image Decreased salt intake
image Eat more fibre
image Physical exercise
image Regularly checking blood sugar & GFR blood tests
Thrombocytopenia image Platelet Transfusion
Increased liver enzymes image Ursodeoxycholic acid (15mg/kg/day)
Severe headache image Practise good sitting posture
image Some amount of rest & relax
image Eat well balanced diet
image Ice pack on head
image Drink plenty of water
image Get enough sleep
Shortness of breath image Nasal saline sprays/ prescription nasal steroids
image Practising good posture
image Sleeping with pillows and supporting the upper back
image Practising breathing technique
Nausea & vomiting image Anti-emetics drugs
Edema particularly in your face & hands image Avoid standing for long periods
image Wear comfortable shoes and socks
image Try to rest with your feet up
image Drink plenty of water
image Decreased salt intake
image Anti-diuretics drugs
Changes in vision image Start eating healthy foods
image Regular exercise
image Get enough sleep, rest to eyes
image Lubricating drops
image It improves after giving birth

Table 3: General treatments include Anti-Hypertensive, Anti-Convulsant & Corticosteroids to patients.

Conclusion

Hypernatremia, Hypokalaemia, Hypocalcaemia & Hypomagnesemia are mainly electrolytes imbalance in preeclampsia condition [14]. Constant monitoring of serum electrolytes should be done to preeclampsia patients [15]. So, supplementation like potassium, calcium, magnesium and control restriction on sodium should done to decrease progression of preeclampsia [16].

References

  1. Lai NK, Martinez D (2019) Physiological roles of parathyroid hormone-related protein. Acta Biomed 90: 510-516.
  2. Indexed at, Crossref, Google Scholar

  3. Indumati K, Kodliwadmath MV, Sheela MK (2011) The Role of serum Electrolytes in Pregnancy induced hypertension. J Clin Diagn Res 5: 66-69.
  4. Indexed at, Crossref, Google Scholar

  5. Hankins GD, Clark SL, Harvey CJ, Uckan EM, Cotton D, et al. (1996) Third-trimester arterial blood gas and acid base values in normal pregnancy at moderate altitude. Obstet Gynecol 88: 347-350.
  6. Indexed at, Crossref, Google Scholar

  7. LoMauro A, Aliverti A (2015) Respiratory physiology of pregnancy: physiology masterclass. Breathe Sheff 11: 297-301.
  8. Indexed at, Crossref, Google Scholar

  9. Ekanem EI, Umoiyoho A, Inyang Otu A (2012) Study of electrolyte changes in patients with prolonged labour in ikot ekpene, a rural community in niger delta region of Nigeria. ISRN Obstet Gynecol 430265.
  10. Indexed at, Crossref, Google Scholar

  11. Belzile M, Pouliot A, Cumyn A, Côté AM (2019) Renal physiology and fluid and electrolyte disorders in pregnancy. Best Pract Res Clin Obstet Gynaecol 57: 1-14.
  12. Indexed at, Crossref, Google Scholar

  13. Ali DS, Dandurand K, Khan AA (2021) Hypoparathyroidism in pregnancy and lactation: current approach to diagnosis and management. J Clin Med 10: 1378.
  14. Indexed at, Crossref, Google Scholar

  15. Almaghamsi A, Almalki MH, Buhary BM (2018) Hypocalcemia in pregnancy: a clinical review update. Oman Med J 33: 453-462.
  16. Indexed at, Crossref, Google Scholar

  17. Rey E, Jacob CE, Koolian M, Morin F (2016) Hypercalcemia in pregnancy – a multifaceted challenge: case reports and literature review. Clin Case Rep 4: 1001-1008.
  18. Indexed at, Crossref, Google Scholar

  19. Appelman Dijkstra NM, Ertl DA, Carola Zillikens M, Rjenmark L, Winter EM, et al. (2021) Hypercalcemia during pregnancy: management and outcomes for mother and child. Endocrine 71: 604-610.
  20. Indexed at, Crossref, Google Scholar

  21. Langer B, Grima M, Coquard C, Bader AM, Schlaeder G, et al. (1998) Plasma active renin, angiotensin I, and angiotensin II during pregnancy and in preeclampsia. Obstet Gynecol 91: 196-202.
  22. Indexed at, Crossref, Google Scholar

  23. Jahnen Dechent W, Ketteler M (2012) Magnesium basics. Clin Kidney J 5: i3-i14.
  24. Indexed at, Crossref, Google Scholar

  25. Swaminathan R (2003) Magnesium metabolism and its disorders. Clin Biochem Rev 24: 47-66.
  26. Indexed at, Crossref, Google Scholar

  27. Fawcett WJ, Haxby EJ, Male DA (1999) Magnesium: physiology and pharmacology. Br J Anaesth 83: 302-320.
  28. Indexed at, Crossref, Google Scholar

  29. Franz KB (1987) Magnesium intake during pregnancy. Magnesium 6: 18-27.
  30. Indexed at, Crossref, Google Scholar

  31. Lim P, Jacob E, Dong S (1969) Values for tissue magnesium as a guide in detecting magnesium deficiency. J Clin Pathol 22: 417-421.
  32. Indexed at, Crossref, Google Scholar

Citation: Reehana S, Meghana M, BABU JA (2023) Preeclampsiainduced Hypernatremia, Hypokalaemia, Hypocalemia and Hypomagnesemia. J Preg Child Health 10: 570.

Copyright: © 2023 Reehana S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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