Preeclampsiainduced Hypernatremia, Hypokalaemia, Hypocalemia and Hypomagnesemia
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
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.
|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.
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
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.
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.
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.
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 . Hypocalcaemia induced preeclampsia – calcium plays a crucial role in the function of vascular smooth muscles . Alternation of plasma calcium concentration leads increase in Blood pressure . Hypomagnesemia induced preeclampsia – magnesium act as a co-factor of many enzymes NA+, K+ATPase involved in peripheral vasodilation . Ca+, Mg+ which acts relaxants effect on blood vessel of pregnant women . Both magnesium and sodium are known to decrease intracellular calcium which leads to smooth muscle contraction. Leads to elevated blood pressure [Table 2].
|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|
|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.
(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.,
General treatment includes Anti-Hypertensive, Anti-Convulsant & Corticosteroids to patients . 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 . According to FDA class of drugs like category-A, B, C are given to preeclampsia patients while D & X are avoided drugs [Table 3].
|Increased BP||Hydralazine (increased risk of maternal hypotension)|
|Sodium nitroprusside (emergency condition, but cyanide crosses placenta fatal toxicity)|
|Proteinuria||Eat less protein|
|Decreased salt intake|
|Eat more fibre|
|Regularly checking blood sugar & GFR blood tests|
|Increased liver enzymes||Ursodeoxycholic acid (15mg/kg/day)|
|Severe headache||Practise good sitting posture|
|Some amount of rest & relax|
|Eat well balanced diet|
|Ice pack on head|
|Drink plenty of water|
|Get enough sleep|
|Shortness of breath||Nasal saline sprays/ prescription nasal steroids|
|Practising good posture|
|Sleeping with pillows and supporting the upper back|
|Practising breathing technique|
|Nausea & vomiting||Anti-emetics drugs|
|Edema particularly in your face & hands||Avoid standing for long periods|
|Wear comfortable shoes and socks|
|Try to rest with your feet up|
|Drink plenty of water|
|Decreased salt intake|
|Changes in vision||Start eating healthy foods|
|Get enough sleep, rest to eyes|
|It improves after giving birth|
Table 3: General treatments include Anti-Hypertensive, Anti-Convulsant & Corticosteroids to patients.
Hypernatremia, Hypokalaemia, Hypocalcaemia & Hypomagnesemia are mainly electrolytes imbalance in preeclampsia condition . Constant monitoring of serum electrolytes should be done to preeclampsia patients . So, supplementation like potassium, calcium, magnesium and control restriction on sodium should done to decrease progression of preeclampsia .
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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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