Water intoxication and oxytocin.

Assay of dru4gs and other trace comzpounds in biologicalfluids. Ml ethodo-logical developmnent in biochemzistry. Does potassium lower blood pressure by increasing sodium excretion? A metabolic study in patients with mild to moderate essential hvpertension. of potassium administration and of potassium deprivation on plasma renin in normal and hypertensive subjects. diuretics, and salt restriction for the management of mild hypertension: a randomised double blind trial. 19 Richards AM, Nicholls MG, Espirer EA, et al. Blood pressure response to moderate sodium restriction and to potassium supplementation in mild essential hypertension. Dietary chloride as a determinant of "sodium-dependent" effect of a vegetarian diet: controlled trial in normotensive subjects. SHORT REPORTS Water intoxication and oxytocin To reduce the time needed for induced abortions some workers have suggested using intravenous oxytocin in 5`, dextrose in addition to extra-amniotic prostaglandin E2.' This technique is popular and regarded as safe. I report on two patients who developed water intoxication during mid-trimester therapeutic abortions. A 31 year old woman (gravida 6, para 4) was admitted for therapeutic abortion in the 15th week of pregnancy. She was a healthy married white woman who had had one of her previous pregnancies terminated in the 12th week of gestation without complications. On admission clinical examination , full blood count, and estimation of serum electrolyte concentrations were carried out; the results were normal. At midday on the day of admission extra-amniotic instillation of 200 ,Lg Dinoprostone (prostaglandin E.) by svringe pump two hourly and intravenous oxytocin 32 IU in 5`0 dextrose solution by IVAC pump were started. After 35 hours she became restless and confused and had a grand mal convulsion. On examination her pupils were widely dilated and unresponsive to light. Tendon reflexes were uniformly brisk and plantar responses extensor. After vaginal examination the Foley catheter and some products of conception were extracted from the introitus. Diazepam 10 mg intravenously and oxygen 4-6 I1min via MC mask were given. The intravenous oxytocin in 5,, dextrose infusion was stopped. Total fluid intake was 2 5 litres with 80 IU oxytocin, and fluid output was two litres urine and 100 ml vomit. Serum sodium concentration was 115 mmol(mEq)ll, urea 3 0 mmol'l (18 mg'100 ml), potassium 3-3 mmol(mEq)ll, haemoglobin 13 4 g,'dl, and packed cell volume 0-27. After two hours of treatment with intravenous 1-80, saline, intramuscular frusemide 60 mg, and methylprednisolone 1 g she had a second seizure. Her condition remained critical …