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What is the effect on the fetus if the mother has diabetes insipidus?

Q: I am very pleased and respect this website and the advice given by you. My wife suffers from diabetes insipidus for the past 10 years and she was taking DDVAP twice (morning and night 0.1mg). Now she is pregnant since 6 months, after 13 years. The problem started after she got pregnant, she became thirsty after taking DDVAP and her body feels burning and so on. The doctors here advised her to not to take DDVAP more than two times a day. For the thirst they advised her to drink water. My question is: 1. Can a diabetes insipidus patient deliver a healthy baby? 2. Is there any side effect for the baby if she takes more DDVAP? 3. Any effect on the baby if she continues to drink more water? 4. Any harm to the mother during delivery? 5. Any possibility that the baby may have this disease? 6. Can the mother breastfeed the baby? 7. What is the best way for delivery? 8. Will there be any complication during the delivery? 9. Is the mother's life at stake? Please help me to clear all my doubts.

A:I would like to mention few points on pregnancy and Diabetes insipidus: 1. During pregnancy due to physiological changes requirement of DDAVP is increased so the dose requirement is higher. 2. Aim of the treatment of this disease during pregnancy is to control symptoms and avoid polyuria increased amount of urine) and dehydration. Dehydration can be harmful to mother as well as to baby. 3. The dose requirement depends upon patient to patient and can be increased till the symptoms are relieved. 4. There is no evidence in literature to suggest any harmful effects of DDAVP on fetus and pregnancy. 5. There is no problem of lactation. 6. Baby is very unlikely to get this disease. I am making this statement on the basis that your wife seems to have a acquired disease rather then hereditary. 7. She can have normal delivery. Disease per se is not a indication for caesarian section. 8. Only complication because of disease during delivery is dehydration and that is easy to avoid. 9. Mothers life is absolutely safe. 10. I would suggest that you can increase the dose of DDAVP and as it is a precious and high risk pregnancy, get the delivery conducted at a good medical centre.

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