Table 2.

Approach to assessing peripartum hyponatraemia

SymptomsDrowsiness and confusion
Past medical historyRenal disease, pancreatitis, liver disease and cardiac failure
Drug historyDiuretics, PPI and oxytocin
Obstetric historyDuration of labour and estimated blood loss
ObservationsTachycardia and blood pressure
Fluid statusJVP, peripheral oedema and crepitations on chest auscultation
Biochemical testsElectrolytes, serum and urine osmolality, and renal profile
Fluid balanceHourly urine output
  • JVP = jugular venous pressure; PPH = postpartum haemorrhage; PPI = proton pump inhibitor.