Table 2.

Approach to assessing peripartum hyponatraemia

History
Symptoms	Drowsiness and confusion
Past medical history	Renal disease, pancreatitis, liver disease and cardiac failure
Drug history	Diuretics, PPI and oxytocin
Obstetric history	Duration of labour and estimated blood loss
Examination
Observations	Tachycardia and blood pressure
Fluid status	JVP, peripheral oedema and crepitations on chest auscultation
Investigations
Biochemical tests	Electrolytes, serum and urine osmolality, and renal profile
Fluid balance	Hourly urine output

JVP = jugular venous pressure; PPH = postpartum haemorrhage; PPI = proton pump inhibitor.