Define gestational diabetes insipidus.
a transient condition due to disruption of the physiologic balance of vasopressinase and ADH secretion during pregnancy, which typically resolves after delivery
What is the cause of gestational DI?
decreased metabolization of vasopressinase due to impairment in hepatic function (e.g., HELLP, AFLP, hemochromatosis)
Describe the pathophysiology.
↓ Peripheral vascular resistance and blood pressure → ↓ threshold for ADH secretion
↑ Vasopressinase secretion from placental trophoblasts after 8 weeks' gestation
↑ Compensatory ADH production
Which diagnostics are used?
24-hour urine collection to confirm polyuria (urine output > 3 L/day)
Desmopressin challenge test —> Ideally without water restriction to avoid the risks of dehydration to the fetus
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