Diabetes insipidus in pregnancy

Abstract

Diabetes insipidus is an uncommon condition with various aetiologies. Recent research has uncovered new mechanisms underlying the syndrome. Careful attention to management is essential in pregnant women to avoid serious complications. Diabetes insipidus in pregnancy may be due to relative reduction in secretion of AVP from the posterior pituitary (cranial DI), increase in breakdown of AVP by placental cystine aminopeptidase with vasopressinase activity, or resistance of the rental tubules to AVP (nephrogenic DI).

Managing severe peripartum hyponatraemia: A case report

“…The first is central diabetes insipidus as a consequence of failed anti-diuretic hormone secretion due to posterior pituitary infarction. 3,4 This presents with thirst and polyuria with normal serum sodium; if water intake falls behind urinary excretion then sodium levels rise with dehydration. The second is disruption of the hypothalamic thirst centres following an ischaemic insult although no significant hyponatraemia was seen in the study.…”

Management of Endocrinopathies in Pregnancy: A Review of Current Evidence

“…A partial explanation would be the transient reduction of the uterine artery flow and of systolic velocity after the administration of short-acting Octreotide [ 120 ]. Pegvisomant (category B—FDA) has proven to be a safe and effective drug; fetal concentration is minimal suggesting a low or absent transplacenta passage [ 120 , 121 ]. Although medical treatment of pregnant women with acromegaly is not associated with major side effects of the mother or fetus, it should be discontinued during pregnancy.…”

“…Diabetes insipidus (DI) is a rare disorder characterized by antidiuretic hormone (ADH) deficiency. Produced in the hypothalamus and stored in the posterior pituitary, ADH acts directly on the distal tubules to allow water reabsorption in response to dehydration [ 121 ]. DI can be a result of ADH hyposecretion in the posterior pituitary gland (central DI, endocrine) or lack of response to its action in the kidney (nephrogenic DI, peripheral) [ 121 ].…”

“…Produced in the hypothalamus and stored in the posterior pituitary, ADH acts directly on the distal tubules to allow water reabsorption in response to dehydration [ 121 ]. DI can be a result of ADH hyposecretion in the posterior pituitary gland (central DI, endocrine) or lack of response to its action in the kidney (nephrogenic DI, peripheral) [ 121 ]. As a result, there is an inability to maintain normal plasma osmolarity (275–295 mmol/L) and urine concentrations (>300 mOsmol/kg).…”

Diabetes insipidus in der Schwangerschaft – ein Fallbericht

“…Zu den Symptomen gehören hypotonische Polyurie, Polydipsie, Müdigkeit, Gewichtsverlust, verminderter Hautturgor und Übelkeit, die sich in der Regel über ein paar Tage entwickeln und dann verschlimmern können, wenn diese Erkrankung nicht richtig erkannt und behandelt wird [5,6].…”