Perioperative anesthetic management for Cesarean section of a parturient with gestational diabetes insipidus.
OBJECTIVE
Gestational diabetes insipidus (GDI) is a rare endocrinopathy complicating about 4:100,000 deliveries. We present the case of a preterm parturient with GDI and severe hypernatremia (serum sodium concentration = 174 mmol.L(-1)) presenting for an urgent Cesarean section.


METHODS
Fluid resuscitation and desmopressin supplementation partially corrected the patient's homeostasis, allowing us to carefully titrate epidural anesthesia for an urgent Cesarean section. After delivery, the patient was transferred to the intensive care unit. The serum sodium concentration of the mother and the neonate was normalized over 48 hr and three days respectively.


CONCLUSIONS
The careful perioperative management of GDI led to a favourable outcome of the mother and fetus.
Lacassie
Hector J
HJ
Division of Women's Anesthesia, Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Bin 9, Durham, NC 27710, USA. lacas001@mc.duke.edu
Muir
Holly A
HA
Millar
Simon
S
Habib
Ashraf S
AS
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D050034:Antidiuretic Agents / Q000627:therapeutic use; D002585:Cesarean Section; D003422:Critical Care; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000097:blood / Q000150:complications*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006955:Hypernatremia / Q000097:blood / Q000150:complications; D007231:Infant, Newborn; D008297:Male; D019990:Perioperative Care; D011247:Pregnancy; D011248:Pregnancy Complications; D012121:Respiration, Artificial; D012964:Sodium / Q000097:blood
D050034:Antidiuretic Agents; D012964:Sodium; D003894:Deamino Arginine Vasopressin