Oxytocin Induced Water Intoxication at Mid-trimester Abortion

目的：使用靜脈注射之人工合成之催產素作為催生或終止妊娠之藥物罕有但嚴重的副作用一水中毒以及低鈉血症一雖少見但不容忽視。我們提出一轉診個案於接受高劑量之催產素導致水中毒後，產生嚴重低鈉血症併發大痙攣及意識喪失。病例報告：一位十七歲女性於妊娠十八週，接受混合於純葡萄糖溶液之高劑量之靜脈注射催產素以中止妊娠。過程中發生大痙攣及意識喪失而轉診至本院，發現乃因催產素導致水中毒併發嚴重低鈉血症，並產生神經學症狀，於嚴密監控電解質及矯正低鈉血症後，恢復正常。結論：在使用不含鈉嬰之靜脈補充液及高劑量之催產素的情形下，可能發生嚴重之低鈉血症，並導致相關症狀發生。使用人工合成催產素，應以保持最低有效劑量，及使用含鹽溶液，以避免此一併發症之發生。

關鍵字

催產素；水中毒；終止妊娠；痙攣

並列摘要

Objective Water intoxication is a rare but serious effect of intravenous synthetic oxytocin in obstetrics, which should not be ignored. Here we present a referred case with generalized seizures due to water intoxication secondary to hyponatremia after receiving intravenous oxytocin in an extremely high dose at a mid-trimester termination. Case Report(s) A 17-year-old female, G1PO, with singleton pregnancy at 18 weeks of gestation, received termination by intravenous oxytocin in a rate over 100 mlU per hour in a 5% dextrose line for sixteen hours, and then developed grand-mal seizure subsequently during abortion at a local clinic. She was immediately transferred to our Hospital with a dead fetus in utero and severe hyponatremia. After hyponatremia was corrected, her consciousness completely recovered without any neurological sequelae. Conclusion(s) We reported this case in order to remind our colleagues the adverse effect of water intoxication when using synthetic oxytocin for induction or termination. To avoid this serious complication by oxytocin, always keep the dose of oxytocin at the lowest effective level. Furthermore, remember to use the sodium-containing intravenous solution, for example, normal saline, or 2.5% dextrose saline, etc. for the intravenous oxytocin infusion.

並列關鍵字

oxytocin ； water intoxication ； mid-trimester ； abortion ； seizure.

國際替代計量

Oxytocin Induced Water Intoxication at Mid-trimester Abortion

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