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).
LindheimerMD. Polyuria and pregnancy: its cause, its danger. Obstet Gynecol2005;105(Part 2):1171–2
2.
ThrasherTN. Osmoreceptor mediation of thirst and vasopressin secretion in the dog. Fed Proc1982;41:2528–32
3.
GauerOH, HenryJP. Neurohormonal control of plasma volume. Int Rev Physiol1976;9:145–90
4.
DunnFL, BrennanTJ, NelsonAE, RobertsonGL. The role of blood osmolality and volume in regulating vasopressin secretion in the rat. J Clin Invest1973;52:3212–9
5.
AgreP, KingLS, YasuiM, Aquaporin water channels – from atomic structure to clinical medicine. J Physiol2002;542(Part 1):3–16
6.
SchrierRW. Body water homeostasis: clinical disorders of urinary dilution and concentration. J Am Soc Nephrol2006;17:1820–32
7.
KingLS, ChoiM, FernandezPC, CartronJP, AgreP. Defective urinary-concentrating ability due to a complete deficiency of aquaporin-1. N Engl J Med2001;345:175–9
8.
MaT, SongY, YangB, Nephrogenic diabetes insipidus in mice lacking aquaporin-3 water channels. Proc Natl Acad Sci USA2000;97:4386–91
9.
DavisonJM, VallottonMB, LindheimerMD. Plasma osmolality and urinary concentration and dilution during and after pregnancy: evidence that lateral recumbency inhibits maximal urinary concentrating ability. Br J Obstet Gynaecol1981;88:472–9
10.
LindheimerMD, DavisonJM. Osmoregulation, the secretion of arginine vasopressin and its metabolism during pregnancy. Eur J Endocrinol1995;132:133–43
11.
DavisonJM, SheillsEA, PhilipsPR, BarronWM, LindheimerMD. Metabolic clearance of vasopressin and an analogue resistant to vasopressinase in human pregnancy. Am J Physiol1993;264(Part 2):F348–53
12.
OharaM, MartinPY, XuDL, Upregulation of aquaporin 2 water channel expression in pregnant rats. J Clin Invest1998;101:1076–83
13.
CheongHI, ParkHW, HaIS, Six novel mutations in the vasopressin V2 receptor gene causing nephrogenic diabetes insipidus. Nephron1997;75:431–7
14.
LustK, McIntyreHD, MortonA. Sheehan's syndrome – acute presentation with hyponatraemia and headache. Aust N Z J Obstet Gynaecol2001;41:348–51
15.
SchwartzAR, LeddyAL. Recognition of diabetes insipidus in postpartum hypopituitarism. Obstet Gynecol1982;59:394–8
