In the pregnant patient, hypotonic polyuria in the setting of elevated serum osmolality and polydipsia should narrow the differential to causes related to diabetes insipidus (DI). Gestational DI, also called transient DI of pregnancy, is a distinct entity, unique from central DI or nephrogenic DI which may both become exacerbated during pregnancy. These three different processes relate to vasopressin, where increased metabolism, decreased production or altered renal sensitivity to this neuropeptide should be considered. Gestational DI involves progressively rising levels of placental vasopressinase throughout pregnancy, resulting in decreased endogenous vasopressin and resulting hypotonic polyuria worsening through the pregnancy. Gestational DI should be distinguished from central and nephrogenic DI that may be seen during pregnancy through use of clinical history, urine and serum osmolality measurements, response to desmopressin and potentially, the newer, emerging copeptin measurement. This review focuses on a brief overview of osmoregulatory and vasopressin physiology in pregnancy and how this relates to the clinical presentation, pathophysiology, diagnosis and management of gestational DI, with comparisons to the other forms of DI during pregnancy. Differentiating the subtypes of DI during pregnancy is critical in order to provide optimal management of DI in pregnancy and avoid dehydration and hypernatremia in this vulnerable population.

在孕妇中，低渗性多尿症在血清渗透压升高和烦躁不安的情况下，应将差异缩小至与尿崩症（DI）相关的原因。妊娠期DI，也称为妊娠短暂性DI，是一个独特的实体，不同于中枢性DI或肾源性DI，它们在妊娠期间都可能加剧。这三种不同的过程与血管加压素有关，应考虑增加新陈代谢，降低产量或改变肾脏对该神经肽的敏感性。妊娠期DI涉及整个妊娠过程中胎盘血管加压素水平的逐步升高，导致内源性血管加压素减少，并导致低渗性多尿症在妊娠期间恶化。妊娠期DI应与妊娠期间通过临床病史，尿液和血清渗透压测定，对去氨加压素的反应以及可能出现的新的肽素测定而发现的中枢性和肾源性DI区分开来。这篇综述着重于妊娠渗透调节和血管加压素生理的简要概述，以及这与妊娠DI的临床表现，病理生理，诊断和管理的关系，并与妊娠期间其他形式的DI进行比较。区分怀孕期间DI的亚型至关重要，这是为了在怀孕期间提供最佳的DI管理，并避免在这个脆弱人群中出现脱水和高钠血症。新兴的肽素测量。这篇综述着重于妊娠渗透调节和血管加压素生理的简要概述，以及这与妊娠DI的临床表现，病理生理，诊断和管理的关系，并与妊娠期间其他形式的DI进行比较。区分怀孕期间DI的亚型至关重要，这是为了在怀孕期间提供最佳的DI管理，并避免在这一脆弱人群中出现脱水和高钠血症。新兴的肽素测量。这篇综述着重于妊娠渗透调节和血管加压素生理的简要概述，以及这与妊娠DI的临床表现，病理生理，诊断和管理的关系，并与妊娠期间其他形式的DI进行比较。区分怀孕期间DI的亚型至关重要，这是为了在怀孕期间提供最佳的DI管理，并避免在这个脆弱人群中出现脱水和高钠血症。