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Polyuria and diabetes insipidus of pregnancy

Authors
Ravi I Thadhani, MD, MPH
Sharon E Maynard, MD
Section Editors
Richard J Glassock, MD, MACP
Richard H Sterns, MD
Deputy Editors
Kristen Eckler, MD, FACOG
John P Forman, MD, MSc

INTRODUCTION

Polyuria, a common complaint during normal pregnancy, is also one symptom of diabetes insipidus (DI). DI in pregnancy can be transient as a result of pregnancy-induced changes or represent worsening of preexisting disease from either central or nephrogenic causes. Recognition and management of DI during pregnancy is important because settings of water restriction can result in serious neurologic consequences in both the mother and fetus.

This topic will discuss the clinical presentation, evaluation and diagnosis, and management of DI in pregnant women. Related topics on polyuria and DI are presented separately:

(See "Diagnosis of polyuria and diabetes insipidus".)

(See "Urine output in diabetes insipidus".)

(See "Clinical manifestations and causes of nephrogenic diabetes insipidus".)

               
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Literature review current through: Nov 2017. | This topic last updated: Nov 30, 2017.
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References
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  1. Robertson GL. Antidiuretic hormone. Normal and disordered function. Endocrinol Metab Clin North Am 2001; 30:671.
  2. Ananthakrishnan S. Diabetes insipidus during pregnancy. Best Pract Res Clin Endocrinol Metab 2016; 30:305.
  3. Hime MC, Richardson JA. Diabetes insipidus and pregnancy. Case report, incidence and review of literature. Obstet Gynecol Surv 1978; 33:375.
  4. Durr JA, Lindheimer MD. Diagnosis and management of diabetes insipidus during pregnancy. Endocr Pract 1996; 2:353.
  5. Kennedy S, Hall PM, Seymour AE, Hague WM. Transient diabetes insipidus and acute fatty liver of pregnancy. Br J Obstet Gynaecol 1994; 101:387.
  6. Dürr JA. Diabetes insipidus in pregnancy. Am J Kidney Dis 1987; 9:276.
  7. Iwasaki Y, Oiso Y, Kondo K, et al. Aggravation of subclinical diabetes insipidus during pregnancy. N Engl J Med 1991; 324:522.
  8. Ford SM Jr, Lumpkin HL 3rd. Transient vasopressin-resistant diabetes insipidus of pregnancy. Obstet Gynecol 1986; 68:726.
  9. Lindheimer MD, Barron WM, Davison JM. Osmotic and volume control of vasopressin release in pregnancy. Am J Kidney Dis 1991; 17:105.
  10. Durr JA, Hoggard JG, Hunt JM, Schrier RW. Diabetes insipidus in pregnancy associated with abnormally high circulating vasopressinase activity. N Engl J Med 1987; 316:1070.
  11. Brewster UC, Hayslett JP. Diabetes insipidus in the third trimester of pregnancy. Obstet Gynecol 2005; 105:1173.
  12. Aleksandrov N, Audibert F, Bedard MJ, et al. Gestational diabetes insipidus: a review of an underdiagnosed condition. J Obstet Gynaecol Can 2010; 32:225.
  13. Sherer DM, Cutler J, Santoso P, et al. Severe hypernatremia after cesarean delivery secondary to transient diabetes insipidus of pregnancy. Obstet Gynecol 2003; 102:1166.
  14. Katz VL, Bowes WA Jr. Transient diabetes insipidus and preeclampsia. South Med J 1987; 80:524.
  15. Matsuzaki S, Endo M, Ueda Y, et al. A case of acute Sheehan's syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage. BMC Pregnancy Childbirth 2017; 17:188.
  16. Yeung EH, Liu A, Mills JL, et al. Increased levels of copeptin before clinical diagnosis of preelcampsia. Hypertension 2014; 64:1362.
  17. Lindheimer MD. Polyuria and pregnancy: its cause, its danger. Obstet Gynecol 2005; 105:1171.
  18. Davison JM, Sheills EA, Philips PR, et al. Metabolic clearance of vasopressin and an analogue resistant to vasopressinase in human pregnancy. Am J Physiol 1993; 264:F348.
  19. Ray JG. DDAVP use during pregnancy: an analysis of its safety for mother and child. Obstet Gynecol Surv 1998; 53:450.
  20. Hanson RS, Powrie RO, Larson L. Diabetes insipidus in pregnancy: a treatable cause of oligohydramnios. Obstet Gynecol 1997; 89:816.
  21. Hadi HA, Mashini IS, Devoe LD. Diabetes insipidus during pregnancy complicated by preeclampsia. A case report. J Reprod Med 1985; 30:206.
  22. Mor A, Fuchs Y, Zafra K, et al. Acute presentation of gestational diabetes insipidus with pre-eclampsia complicated by cerebral vasoconstriction: a case report and review of the published work. J Obstet Gynaecol Res 2015; 41:1269.