Diabetes insipidus and pregnancy

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Reproductive Medicine

Background:

• Diabetes insipidus (DI) is a rare pregnancy complication.
• It can be transient, caused by placental vasopressinase, or acquired due to conditions like hypophysitis.
• Pregnancy can also unmask pre-existing central or nephrogenic DI.

Purpose of the Study:

• To review the causes and management of diabetes insipidus during pregnancy.
• To highlight the efficacy of desmopressin (dDAVP) in treating specific types of DI in pregnancy.

Main Methods:

• Literature review of diabetes insipidus in pregnancy.
• Analysis of treatment strategies, focusing on dDAVP efficacy.
• Comparison of transient, acquired, and pre-existing DI management.

Main Results:

• Transient gestational DI resolves post-delivery.
• Acquired and pre-existing central DI respond well to dDAVP.
• Nephrogenic DI is resistant to dDAVP, posing treatment challenges during pregnancy.

Conclusions:

• Desmopressin (dDAVP) is a highly effective treatment for most pregnancy-related DI, excluding nephrogenic DI.
• Understanding the etiology of DI is crucial for appropriate management during pregnancy.
• Nephrogenic DI requires careful management, potentially involving fluid intake restriction.