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Diabetes Insipidus in the Third Trimester of Pregnancy

Brewster, Ursula C. MD; Hayslett, John P. MD

doi: 10.1097/01.AOG.0000161811.02155.68
Case Reports
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BACKGROUND: Transient diabetes insipidus may rarely present during late pregnancy and/or the immediate puerperium, and if unrecognized, may cause neurologic injury and threaten the lives of mother and fetus. However, when recognized early and treatment is initiated with desmopressin acetate, an analog of vasopressin that is resistant to vasopressinase, water loss in the urine is eliminated and complications may be abrogated. This report aims to increase the awareness of this disorder and describes appropriate treatment.

CASES: Two cases of diabetes insipidus, believed to be due to excess vasopressinase, are presented to demonstrate the clinical features, pathogenesis, and treatment of this syndrome.

CONCLUSION: Awareness of the syndrome of transient diabetes insipidus may lead to early diagnosis and appropriate treatment that will reduce the risks of maternal and fetal morbidity.

Transient diabetes insipidus of pregnancy with life-threatening hypernatremia may result when circulating vasopressinase overwhelms pituitary arginine vasopressin secretion, but it is easily treated.

Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut

Received February 4, 2005. Received in revised form February 19, 2005. Accepted February 25, 2005.

Address reprint requests to: Ursula C. Brewster, MD, Section of Nephrology, Yale University School of Medicine, FMP 107, 330 Cedar Street, PO Box 208029, New Haven, CT 06520–8029; e-mail: ursula.brewster@yale.edu

© 2005 The American College of Obstetricians and Gynecologists