CENTRAL DIABETES INSIPIDUS AND PREGNANCY: CLINICAL CASE AND LITERATURE REVIEW

Abstract

Diabetes insipidus is a rare endocrine disorder, caused by antidiuretic hormone deficiency, and resulting in a disturbed balance of water and electrolytes in the body. The aim of this work was, based on literature data, to evaluate the features of the manifestation of central diabetes insipidus during pregnancy, the possibilities of treatment and monitoring its effectiveness. We present a clinical case of central diabetes insipidus during pregnancy that reflects the possible influence of pregnancy on the mentioned disorder and the applied treatment. The diagnosis of central diabetes insipidus can be made for the first time during pregnancy; however, encountering pregnant women who experience an exacerbation of pregestational central diabetes insipidus is more common. Desmopressin, a synthetic analogue of vasopressin, is prescribed for treatment, preferring its sublingual form. Clinical signs such as increased urination, change in urine color, increased thirst, impaired consciousness, weakness, or convulsions caused by hypernatremia, as well as laboratory tests evaluating blood and urine osmolality, urine specific gravity and sodium concentration in blood plasma are important for evaluating the effectiveness of treatment. Monitoring of pregnant women and timely diagnosis of this disease are extremely important in clinical practice, because the treatment is very simple, effective and helps to avoid possible complications for both the mother and the fetus.