Gestational diabetes insipidus

During pregnancy, all women produce vasopressinase in placenta, which breaks down ADH. Women with Gestational DI is thought to have excessive vasopressinase production. It can be treated as usual with desmopressin. Before starting treatment, care should be taken first to rule out pregnancy induced Dipsogenic DI where desmopressin is contraindicated.

Clinical Significance: Gestational Diabetes insipidus may be a warning sign of some serious underlying pathophysiology including pre-eclampsia, HELLP Syndrome or acute fatty liver of pregnancy. Delay in diagnosis and treatment may lead to maternal or perinatal mortality.