Hanson R S, Powrie R O, Larson L
Department of Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, USA.
Obstet Gynecol. 1997 May;89(5 Pt 2):816-7. doi: 10.1016/s0029-7844(97)00029-x.
Diabetes insipidus, which presents with polyuria, polydipsia, and profound electrolyte abnormalities, occurs rarely in pregnancy. We report a patient with severe oligohydramnios that resolved after treatment of diabetes insipidus.
A 14-year-old girl was admitted at 33 weeks' gestation with cramping and vaginal spotting. A sonogram indicated oligohydramnios and an amniotic fluid index (AFI) of 2.6, with normal fetal kidneys and bladder. On hospital day 2, the AFI was 0.0. Recorded fluid was 8 L in and 13.6 L out. Serum sodium was 153 mEq/L. Diabetes insipidus was diagnosed and treated with intranasal desmopressin acetate. The oligohydramnios resolved rapidly, and the patient delivered a healthy 2700-g male infant at 38 weeks.
Although rare, diabetes insipidus may present initially in pregnancy and should be considered in patients with oligohydramnios. Simple diagnosis with determination of 24-hour urine volume and serum electrolytes can identify this potentially reversible cause of oligohydramnios and poor obstetric outcome.
尿崩症表现为多尿、烦渴和严重的电解质紊乱，在妊娠期间很少发生。我们报告一例严重羊水过少患者，在尿崩症治疗后羊水过少得到缓解。
一名14岁女孩在妊娠33周时因腹痛和阴道点滴出血入院。超声检查显示羊水过少，羊水指数（AFI）为2.6，胎儿肾脏和膀胱正常。住院第2天，AFI为0.0。记录的入量为8L，出量为13.6L。血清钠为153mEq/L。诊断为尿崩症，并给予醋酸去氨加压素滴鼻治疗。羊水过少迅速缓解，患者在38周时分娩出一名健康的2700g男婴。
虽然罕见，但尿崩症可能在妊娠初期出现，羊水过少的患者应考虑该病。通过测定24小时尿量和血清电解质进行简单诊断，可以识别这种可能导致羊水过少和不良产科结局的可逆原因。
