Neonatal Med.  2021 Nov;28(4):149-152. 10.5385/nm.2021.28.4.149.

Hypernatremia in Newborn Due to Uncontrolled Maternal Diabetes Insipidus

• Lee K
• Kim ES
• Cho KH

• KMID: 2522851
• DOI: http://doi.org/10.5385/nm.2021.28.4.149

Abstract

Neonatal hypernatremia often occurs in poorly breastfeeding infants, and rehydration without complications is the primary treatment. However, the etiologies and management for neonates who present with hypernatremia immediately after birth are not well reported. In this case report, we describe a neonate with hypernatremia and hyperosmolality, born to a mother with oligohydramnios of unknown etiology. Meticulous fluid therapies considering the time to physiologic diuresis were successfully performed, and the underlying cause was determined to be an uncontrolled maternal central diabetes insipidus.

Keyword

Hypernatremia; Infant, newborn; Diabetes insipidus; Oligohydramnios

Figure

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  Figure 1. Immediately after birth, the infant was shown to have decreased skin turgor and wrinkles on the extremities. Her abdomen was scaphoid with audible bowel sounds.

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  Figure 2. Clinical and laboratory changes after birth. Trophic feeding was started and maintained until 68 hours after birth, and fluid therapies were changed according to calculated free water deficit, plasma sodium level, and urine output. Abbreviations: Na, sodium; U/O, urine output; K, potassium; Cl, chloride; BUN, blood urea nitrogen; Cr, creatinine; Hb, hemoglobin; Osm, osmolality; D5% saline, normal saline (0.9%) with 5% dextrose; D5% half saline, 0.45% normal saline with 5% dextrose; D10%, 10% dextrose.

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