This guidance (commissioned via GAIN / RQIA) addresses the particular risks of dilutional hyponatraemia (low sodium levels due to excess hypotonic fluid) in labouring women and the immediate postpartum period, with a focus on prevention, timely diagnosis, and safe management.
It summarises the evidence and offers consensus recommendations for:
- Monitoring fluid and electrolyte balance in pregnant women, especially during labour
- Recognising signs and symptoms of hyponatraemia (e.g. headache, nausea, confusion, seizures)
- Guidelines for fluid administration (oral and intravenous), careful sodium monitoring, and thresholds for action
- Management of symptomatic hyponatraemia, and escalation to obstetric, anaesthetic, or neonatal teams where needed.
The document includes appendices with practical tools (e.g. fluid‐balance charts) and references to general adult hyponatraemia guidance (GAIN) adapted for the peripartum context.
This guideline is a valuable reference for midwives, obstetricians, anaesthetists, and maternity care teams to reduce the risk of maternal and neonatal complications from fluid overload in labour.