30 years woman, presented at 18week pregnancy, G3P2L1D1 A1, diagnosed as Central Diabetes Insipidus following her last delivery,3yrs back , was on dressmopressin 0.2mg /day since then. Fasting blood levels normal, specific gravity of the urine: 1006; no glucosuria or proteinuria . Urinary and plasma osmolality were 245 and 287 mOsm/l; water intake about 2700mL/day; diuresis 2000mL/day. On the basis of the value of urine output and osmolality the dose of desmopressin was Increased at 0.4mg/day. Monthly evaluation of fluid balance, urine volume, osmolality, and serum electrolytes done. Daily dosage was 0.4mg /day for all the duration of pregnancy according to a trend of an adequate fluid and electrolytes balance and in absence of symptoms. Mean blood Pressure was 120/80 mmHg; coagulation, liver, renal function were normal. Fetal monitoring with periodic ultrasound detected a normal intrauterine growth. Patient dev 140/90 bp at 36weeks, managed with salt restriction , bed rest. Elective lscs under spinal anesthesia, healthy male baby at the 38th week. Because of her previous 2 lscs. Despite a previous Central Diabetes Insipidus may worsen in a pregnant with impaired reserve of Ant diuretic Contrary to expectations the need of desmopressin did not increase during the weeks.
