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[Euglycemic diabetic ketoacidosis during pregnancy]
Hester D Kamphof1,2, Vivienne De Smet3, Nicoline E Jansen1
1Ziekenhuis Gelderse Vallei, afd. Gynaecologie, Ede.
Nederlands Tijdschrift Voor Geneeskunde
|August 4, 2021
Summary
Euglycemic diabetic ketoacidosis (DKA) in pregnancy presents challenges due to normal blood glucose levels. Swift recognition and treatment are crucial for maternal and fetal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Neonatology
Background:
- Diabetic ketoacidosis (DKA) can manifest atypically during pregnancy.
- Euglycemic DKA, characterized by normal blood glucose, complicates diagnosis in pregnant patients.
Observation:
- A 34-year-old Type 1 diabetes mellitus (DM1) patient at 31 weeks gestation presented with reduced fetal movements and nausea.
- She experienced severe euglycemic DKA after reducing insulin pump dosage, leading to abnormal fetal monitoring and preterm birth threat.
Findings:
- The patient received insulin, glucose, and bicarbonate. Delivery via emergency cesarean section was performed due to fetal distress.
- The neonate weighed 4820g, had Apgar scores of 5/8/8, and a cord blood pH of 7.14, requiring a week of intravenous glucose.
Implications:
- Euglycemic DKA in pregnancy necessitates prompt diagnosis and management.
- This case highlights the diagnostic challenges and potential adverse fetal outcomes associated with this condition.
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