pituitrin and Puerperal-Disorders

To review the etiology, diagnosis, and management of diabetes insipidus during pregnancy.. A search of the literature was performed in PubMed using key word searching and citation snowballing to identify articles published in English between January 1, 1980, and December 31, 2008, on the subject of diabetes insipidus during pregnancy. Once the articles were identified, a thorough review of all results was conducted. Results and conclusions were compiled and summarized.. We reviewed 50 studies selected using the following key words: diabetes insipidus, pregnancy, arginine vasopressin, vasopressinase.. Gestational diabetes insipidus is underdiagnosed because polyuria is often considered normal during pregnancy. Clinicians caring for pregnant women should consider screening for gestational diabetes insipidus, because it could be associated with serious underlying pathology.

Topics: Antidiuretic Agents; Body Water; Deamino Arginine Vasopressin; Diabetes Insipidus; Diabetes, Gestational; Diuretics; Female; Humans; Hydrochlorothiazide; Magnetic Resonance Imaging; Pituitary Gland, Posterior; Pregnancy; Puerperal Disorders; Ultrasonography, Prenatal; Vasopressins

The neurohypophyseal function was assessed in a group of 15 patients with postpartum hypopituitarism by measuring plasma arginine-vasopressin concentrations during 5% hypertonic saline infusion. None of the patients had symptoms of diabetes insipidus and all patients were on adequate cortisone and thyroxine replacement therapy before testing. The mean basal plasma vasopressin value in the patients (0.6 +/- 0.1 pmol/l) was significantly lower than that in the normal subjects (2.9 +/- 0.3 pmol/l; p < 0.01), whereas the mean serum sodium, plasma osmolality, plasma renin activity and serum aldosterone values were similar in the two groups. During the osmolar load (5% hypertonic saline), the patients revealed varying degrees of arginine-vasopressin responses to the increase in plasma osmolality. Three patients showed normal arginine-vasopressin responses, 10 had subnormal responses, and 2 had no response. During the dehydration test, the patients revealed significantly lower maximum urine osmolalities (p < 0.0025) with significantly higher concurrent mean plasma osmolality (p < 0.0025) than the controls. None of the patients showed overt polyuria at the time of the study. The results indicate the impaired osmoregulation of arginine-vasopressin secretion to an osmolar stimuli in patients with postpartum hypopituitarism, suggesting neurohypophyseal damage. In patients with Sheehan's syndrome, partial diabetes insipidus seems to be much more frequent than previously believed.

Topics: Adult; Aldosterone; Female; Humans; Hypopituitarism; Middle Aged; Osmosis; Pituitary Gland; Puerperal Disorders; Radioimmunoassay; Renin; Saline Solution, Hypertonic; Vasopressins; Water Deprivation

Topics: Adult; Diabetes Insipidus; Drug Resistance; Female; Humans; Pregnancy; Pregnancy Complications; Puerperal Disorders; Vasopressins

Topics: Animals; Cattle; Cattle Diseases; Drug Combinations; Estradiol; Female; Oxytocin; Postpartum Period; Pregnancy; Puerperal Disorders; Uterus; Vasopressins

Topics: Eclampsia; Female; Headache; Humans; Hypertension; Methylergonovine; Obstetric Labor Complications; Pregnancy; Pregnancy Complications, Cardiovascular; Puerperal Disorders; Syndrome; Vasopressins

Topics: Adult; Chlorides; Diagnosis, Differential; Epilepsy; Female; Humans; Hypertension; Hyponatremia; Porphyrias; Porphyrins; Pregnancy; Puerperal Disorders; Vasopressins

Topics: Adult; Age Factors; Animals; Behavior, Animal; Diabetes Insipidus; Female; Headache; Humans; Hypertonic Solutions; Hypopituitarism; Hypothalamo-Hypophyseal System; Kidney; Necrosis; Osmolar Concentration; Oxytocin; Parity; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders; Vasopressins; Water-Electrolyte Balance

Topics: Adult; Creatinine; Diabetes Insipidus; Diuresis; Electric Conductivity; Female; Humans; Labor, Obstetric; Lactation; Neurophysiology; Osmolar Concentration; Oxytocin; Parity; Postpartum Period; Pregnancy; Pregnancy Complications; Puerperal Disorders; Sodium; Uterus; Vasopressins

Topics: Adult; Blood Volume; Blood Volume Determination; Cardiac Output; Cardiovascular System; Diabetes Insipidus; Female; Heart Rate; Humans; Injections, Intravenous; Kidney Diseases; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Vascular Resistance; Vasopressins

Topics: Adolescent; Adult; Anorexia Nervosa; Female; Humans; Hypothalamus; Oxytocin; Pregnancy; Psychophysiologic Disorders; Puerperal Disorders; Vasopressins