임신 3분기 중 발현된 요붕증 = Endocrinology-metabolism Gestational diabetes insipidus in the third trimester of pregnancy

다국어 초록 (Multilingual Abstract)

Gestational diabetes insipidus, which occurs rarely during late pregnancy, may injure the mother and fetus neurologically. It takes place in about 4 of every 100,000 pregnancies. Increased placental-derived vasopressinase in late pregnancy markedly degrades vasopressin. The decreased vasopressin activity causes hypotonic polyuria, polydipsia, and dehydration. We report a woman with gestational diabetes insipidus who had no abnormal laboratory tests before developing symptoms. The diabetes insipidus was controlled well by administering nasal desmopressin (1-desamino-8-D-arginine vasopressin, DDAVP) followed by resolution of the signs and symptoms after delivery. Although gestational diabetes insipidus is rare, a prompt diagnosis and appropriate treatment to reduce the risks of maternal and fetal injury are important. (Korean J Med 77:512-516, 2009)

참고문헌 (Reference)

1 유순집, "임신중 발현된 중추성 요붕증 2예" 7 : 384-390, 1992

2 이승호, "임신과 동반된 중추성 요붕증 2예" 대한산부인과학회 49 (49): 668-674, 2006

3 전현철, "임신과 동반된 요붕증 2예" 32 : 1457-1461, 1989

4 최범순, "산욕기에 발현된 중추성 요붕증 1예" 12 : 315-320, 1997

5 Ford SM Jr, "Transient vasopressin-resistant diabetes insipidus of pregnancy" 68 : 726-728, 1986

6 Yamanaka Y, "Transient postpartum diabetes insipidus in twin pregnancy associated with HELLP syndrome" 30 : 273-275, 2002

7 Kalelioglu I, "Transient gestational diabetes insipidus diagnosed insuceesive pregnancies: review of pathophysiology, diagnosis, treatment, and management of delivery" 10 : 87-93, 2007

8 Krege J, "Transient diabetes insipidus of pregnancy" 44 : 789-795, 1989

9 Verbalis JG, "Posterior pituitary. in: Cecil medicine. 23rd" Saunders Elsevier 1691-1698, 2007

10 Lindheimer MD, "Osmoregulation, the secretion of arginine vasopressin and its metabolism during pregnancy" 132 : 133-143, 1995

11 Lindheimer MD, "Osmoregulation of thirst and vasopressin release in pregnancy" 257 : F159-F169, 1989

12 Hamai Y, "Differential clinical courses of pregnancies complicated by diabetes insipidus, which does or does not predate the pregnancy" 12 : 1816-1818, 1997

13 Durr JA, "Diabetes insipidus in pregnancy associated with abnormally high circulating vasopressinase activity" 316 : 1070-1074, 1987

14 Durr JA, "Diabetes insipidus in pregnancy" 9 : 276-283, 1987

15 Hutchon DJ, "Desmopressin as a test of urinary concentrating ability in pregnancy" 2 : 206-, 1982

16 Ray JG, "DDAVP use during pregnancy: an analysis of its safety for mother and child" 53 : 450-455, 1998

17 Davison JM, "Altered osmotic thresholds for vasopressin secretion and thirst in human pregnancy" 246 : F105-F109, 1984