Fukuda T, Okutani R, Kono K, Yoshimura Y, Ochiai N
Department of Anesthesiology, Hyogo College of Medicine.
Masui. 1993 Oct;42(10):1511-6.
A 26-year old woman presented with acute hepato-renal dysfunction, coagulation abnormalities and diabetes insipidus associated with hypernatremia in the latter term of pregnancy (39 weeks). Such transient diabetes insipidus during pregnancy as in this case has been reported to be resistant to AVP, but to respond to DDAVP. Because of fetal compromise, an urgent cesarean section was performed. Spinal anesthesia was chosen because of the possible deleterious effects of general anesthesia on liver function. After delivery of twin babies, her symptoms recovered gradually. In conclusion, diabetes insipidus during pregnancy as in this case is transient and disappear after delivery. However, multiple organ dysfunction may become worse and cause fetal death, unless surgical procedure with appropriate anesthetic management is performed.
一名26岁女性在妊娠晚期（39周）出现急性肝肾功不全、凝血异常及与高钠血症相关的尿崩症。据报道，本例这种妊娠期短暂性尿崩症对血管加压素（AVP）耐药，但对去氨加压素（DDAVP）有反应。由于胎儿窘迫，遂行急诊剖宫产。因全身麻醉可能对肝功能产生有害影响，故选择脊髓麻醉。娩出双胞胎后，她的症状逐渐恢复。总之，本例妊娠期尿崩症是短暂性的，产后消失。然而，除非进行适当麻醉管理的手术操作，多器官功能障碍可能会加重并导致胎儿死亡。
