TRANSIENT DIABETES-INSIPIDUS AND ACUTE FATTY LIVER OF PREGNANCY

Objectived To review the association of transient diabetes insipidus a nd acute fatty liver of Objective pregnancy. Design A retrospective st udy. Setting Six women presenting with polyuria and polydipsia int he third trimester or in the immediate postpartum period, referred over a two and a half year period; five out of six were primigravida. All ha d raised liver transaminases and biopsy-proven acute fatty liver of pr egnancy. Four out of six also had pre-eclampsia. Subjects Tertiary ref erral centre. Main outcome measures There were no maternal deaths and only one fetal death. Desamino-cys-1-D-arg-8-vasopressin administratio n produced a reduction in urine output in all five women to whom it wa s administered. In all cases symptoms had resolved by the end of the f ourth postpartum week. Three of the women have had subsequent pregnanc ies uncomplicated by either transient diabetes insipidus or acute fatt y liver of pregnancy. Conclusions The association of transient diabete s insipidus and acute fatty liver of pregnancy appears more common tha n previously recognised. Both may be part of the spectrum of preeclamp sia.