318. POLYURIA IN PREGNANCY – CHALLENGES OF DIAGNOSIS!
A. Sakthivel A , A. J. Nankervis A , J. Conn A , J. Oats A and S. Chitturi BA Endocrinology Services, The Royal Women’s Hospital, Parkville, VIC, Australia.
B Endocrinology, Royal Darwin Hospital, Darwin, NT, Australia.
Reproduction, Fertility and Development 22(9) 118-118 https://doi.org/10.1071/SRB10Abs318
Published: 6 September 2010
Abstract
Increased urinary frequency is a widely experienced symptom in pregnancy; true polyuria is less common and can have a number of causes. It is essential, however that it should be recognized and appropriately investigated, as it may be potentially life threatening to mother and fetus. Diabetes insipidus (DI) is a rare complication of pregnancy. It can be the first presentation of pre-gestational DI, gestational DI or DI associated with acute fatty liver of pregnancy. The latter conditions are illustrated by the following two clinical cases. Osmotic homeostasis can be altered in pregnancy due to resetting of the osmostat and degradation of vasopressin by vasopressinase secreted by the placenta in increasing quantities in the 2nd and 3rd trimesters. Liver failure results in the availability of higher circulating levels of vasopressinase. These cases highlight the difficulties and importance of diagnosis and treatment. Pregnant women often report polyuria during the 3rd trimester. It is important to have a high level of clinical suspicion for the pathological causes, despite the non-specific presentation as underlying conditions can have catastrophic sequelae.
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