Gestational diabetes insipidus is an uncommon condition that occurs during pregnancy and is characterized by an increase in urine output and more frequent urination due to the breakdown of a hormone called vasopressin. This hormone is responsible for helping the body retain fluids, and when the body becomes less responsive to vasopressin or produces inadequate amounts of it, diabetes insipidus develops. This condition, also known as arginine vasopressin disorder (AVD), can lead to a person passing more urine with a paler and weaker color compared to those without AVD.
Damage to specific parts of the brain, such as the pituitary gland, is commonly responsible for AVD. However, during pregnancy, the gestational form of arginine vasopressin disorder (gAVP-D) can occur, leading to the destruction of vasopressin. This rare condition, affecting about 1 in every 30,000 pregnancies, is caused by the creation of an enzyme called vasopressinase by placenta cells known as trophoblasts. As the pregnancy progresses, the number of trophoblasts significantly increases, causing a faster breakdown of vasopressin and reducing water reabsorption in the body.
Symptoms of gAVP-D include excessive thirst, frequent urination, and passing a high volume of light-colored urine. One of the complications associated with gAVP-D is dehydration, which may lead to adverse effects on pregnancy outcomes and reduce the effectiveness of anesthetic medications during delivery. Despite these potential risks, doctors often underdiagnose gAVP-D as the symptoms of increased urination during pregnancy are commonly attributed to the natural changes in the body.
Water deprivation tests are typically used to diagnose AVD, but they may not be routinely administered during pregnancy due to potential risks to the fetus. Instead, doctors may utilize urine and blood tests, as well as MRI scans, to rule out other possible causes of excessive urination during pregnancy. Desmopressin, a synthetic version of vasopressin, is commonly used to treat gAVP-D by replacing the hormone and increasing water retention in the body. This treatment is generally safe for both the pregnant individual and the fetus and can help control symptoms and prevent complications.
Gestational diabetes insipidus is a rare pregnancy complication that can have significant effects on the body’s fluid balance and overall health. While the condition typically resolves on its own after delivery, it may recur in future pregnancies. It is essential for healthcare providers to be aware of the symptoms and risks associated with gAVP-D to provide timely diagnosis and treatment to pregnant individuals affected by this condition.