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Diabetes insipidus, Sheehan's syndrome and pregnancy
1Department of obstetrics and gynaecology, Geertruiden Hospital, Deventer, Netherlands. gyndev@knmg.nl
Objective:
To study the role of vasopressin in osmoregulation in two successive pregnancies in a woman with Sheehan's syndrome.
Study Design:
Diabetes insipidus (DI) became manifest during two pregnancies in a woman with postpartum hypopituitarism.
Results:
Water deprivation-vasopressin administration tests demonstrated partial central DI, corrected with vasopressin in week 12, but only with desmopressin in the third trimester, when placental cystylamino peptidase (vasopressinase) contributes to the severity of the DI.
Conclusion:
If DI occurs during pregnancy it may be the first manifestation of a latent central DI, which is often idiopathic, but rarely the first symptom of a pituitary or hypothalamic abnormality. It may also be part of Sheehan's syndrome.