Diabetes insipidus in pregnancy: a treatable cause of oligohydramnios.

Abstract

BACKGROUND:

Diabetes insipidus, which presents with polyuria, polydipsia, and profound electrolyte abnormalities, occurs rarely in pregnancy. We report a patient with severe oligohydramnios that resolved after treatment of diabetes insipidus.

CASE:

A 14-year-old girl was admitted at 33 weeks' gestation with cramping and vaginal spotting. A sonogram indicated oligohydramnios and an amniotic fluid index (AFI) of 2.6, with normal fetal kidneys and bladder. On hospital day 2, the AFI was 0.0. Recorded fluid was 8 L in and 13.6 L out. Serum sodium was 153 mEq/L. Diabetes insipidus was diagnosed and treated with intranasal desmopressin acetate. The oligohydramnios resolved rapidly, and the patient delivered a healthy 2700-g male infant at 38 weeks.

CONCLUSION:

Although rare, diabetes insipidus may present initially in pregnancy and should be considered in patients with oligohydramnios. Simple diagnosis with determination of 24-hour urine volume and serum electrolytes can identify this potentially reversible cause of oligohydramnios and poor obstetric outcome.

• Authors: R S Hanson, R O Powrie, L Larson
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 89 Issue 5 Pt 2 Pg. 816-7 (May 1997) ISSN: 0029-7844 [Print] United States
• PMID: 9166332 (Publication Type: Case Reports, Journal Article)

Chemical References

• Hypoglycemic Agents
• Sodium
• Deamino Arginine Vasopressin

Topics

• Adolescent
• Amniotic Fluid
• Deamino Arginine Vasopressin (therapeutic use)
• Diabetes Insipidus (complications, diagnosis, drug therapy)
• Diagnosis, Differential
• Female
• Humans
• Hypoglycemic Agents (therapeutic use)
• Infant, Newborn
• Male
• Oligohydramnios (diagnostic imaging, etiology)
• Pregnancy
• Pregnancy Complications
• Pregnancy in Adolescence
• Sodium (blood)
• Ultrasonography, Prenatal