INACTIVATION OF THE ANTIDIURETIC ACTIVITYOF VASOPRESSIN DURING PREGNANCY: A REPORT OF A CASE*

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Abstract
A case is reported in which severe diabetes insipidus occured following hypophysectomy performed for carcinoma of the breast in a pregnant patient. During pregnancy, the diabetes insipidus could not be controlled by relatively large doses of vasopressin. Following parturition, the necessity for administration of vasopressin (Pitressin) ceased by the ninth day. A study is described in which a physiologic dose of vasopressin was administered intravenously under standard conditions of water diuresis in the pregnant and in the postpartum periods. The shorter duration of negative free water clearance that was noted pregnancy is attributed to the destruction of vasopressin at an increased rate. Presumably, endogenous antidiuretic hormone was being similarly destroyed. It is suggested that this is due to a circulating enzyme elaborated by the placenta. Recurrence of the polyuria was noted in the preterminal period. This could readily be controlled by the administration of vasopressin.