title: Severe hypernatremia after cesarean delivery secondary to transient diabetes insipidus of pregnancy.
abstract: BACKGROUND
  Transient diabetes insipidus is an uncommon complication of pregnancy, usually manifesting with polydipsia and polyuria. This condition is considered to result from excess placental vasopressinase activity and is managed with deamino D arginine vasopressin.
  
  
  METHODS
  While on restricted oral intake after cesarean delivery, the patient gradually became disoriented and agitated in conjunction with markedly increased urine output disproportional to her intravenous crystalloid fluid intake. Marked hypernatremia of 178 mEq/dL was noted. Urine osmolality was low at 248 mOsm/L. The clinical presentation and electrolyte abnormalities were considered consistent with transient diabetes insipidus of pregnancy. The patient responded well to nasal-spray-administered deamino D arginine vasopressin and increased intravenous fluid intake, with resolution of symptoms and gradual normalization of serum sodium levels.
  
  
  CONCLUSIONS
  Transient diabetes insipidus of pregnancy should be considered in the differential diagnosis of severe hypernatremia in obstetric patients with restricted oral intake after operative delivery.
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York 11203, USA. dmsherer@aol.com
authors: David M
authors: DM
authors: Sherer
authors: Jed
authors: J
authors: Cutler
authors: Paulus
authors: P
authors: Santoso
authors: Sandra
authors: S
authors: Angus
authors: Ovadia
authors: O
authors: Abulafia
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage; D003919:Diabetes Insipidus / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006955:Hypernatremia / Q000209:etiology* / Q000628:therapy; D011182:Postoperative Care / Q000009:adverse effects; D011183:Postoperative Complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis
chemical_list: D003894:Deamino Arginine Vasopressin