Diabetes insipidus in pregnancy: a treatable cause of oligohydramnios.
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.


METHODS
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.


CONCLUSIONS
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.
Hanson
R S
RS
Department of Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, USA.
Powrie
R O
RO
Larson
L
L
D000293:Adolescent; D000653:Amniotic Fluid; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D003919:Diabetes Insipidus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D008297:Male; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D011253:Pregnancy in Adolescence; D012964:Sodium / Q000097:blood; D016216:Ultrasonography, Prenatal
D007004:Hypoglycemic Agents; D012964:Sodium; D003894:Deamino Arginine Vasopressin