Diabetic ketoacidosis complicating pregnancy
Journal of Neonatal-Perinatal Medicine
|March 18, 2017
Summary
Diabetic ketoacidosis (DKA) in pregnancy, often presenting with nausea and vomiting, shows rapid improvement with aggressive treatment. Current management strategies lead to good perinatal outcomes for both mother and fetus.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Perinatology
Background:
- Diabetic ketoacidosis (DKA) in pregnancy poses risks to mother and fetus.
- Limited data exists on DKA treatment response, recovery time, and perinatal outcomes during pregnancy.
Purpose of the Study:
- To investigate precipitating factors, laboratory findings, treatment approaches, and clinical recovery patterns in pregnancies affected by DKA.
- To analyze perinatal outcomes associated with DKA in pregnant individuals.
Main Methods:
- Retrospective cohort study of pregnancies with DKA from October 1999 to June 2015.
- DKA diagnosis confirmed by hyperglycemia, elevated anion gap (>12 mEq/L), low pH (<7.3), low bicarbonate (<15 mEq/L), and presence of ketones.
- Review of DKA episodes and analysis of subsequent perinatal outcomes.
Main Results:
- Identified 33 women with 40 DKA admissions (0.2% incidence).
- Most women had type 1 diabetes (67%); 97% presented with nausea and vomiting.
- Aggressive treatment rapidly resolved hyperglycemia and acidosis within 12 hours in 90% of patients.
Conclusions:
- Nausea and vomiting are key presenting symptoms of DKA in pregnancy.
- Prompt insulin therapy and resuscitation lead to swift improvement in hyperglycemia and acidosis.
- Effective management ensures favorable perinatal outcomes in pregnancies complicated by DKA.
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