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Diabetic ketoacidosis complicating pregnancy
S P Chauhan1, K G Perry, B N McLaughlin
1Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Summary
Aggressive management of pregnant diabetics significantly reduced diabetic ketoacidosis incidence and fetal death. This approach improved outcomes for both mothers and newborns.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Maternal-Fetal Medicine
Background:
- Pregnancy alters physiology, increasing risks for diabetic ketoacidosis in pregnant women.
- Diabetic ketoacidosis during pregnancy poses significant risks to maternal and fetal well-being.
Purpose of the Study:
- To describe physiologic changes predisposing pregnant women to diabetic ketoacidosis.
- To evaluate the impact of aggressive management protocols on diabetic ketoacidosis in pregnant patients.
Main Methods:
- Implementation of a strict glucose homeostasis surveillance protocol for pregnant diabetic patients in 1982.
- Early recognition and aggressive treatment strategies for diagnosed diabetic ketoacidosis cases.
Main Results:
- Incidence of diabetic ketoacidosis decreased from 22% (1976-1981) to 3% (1986-1991).
- Fetal death rate associated with diabetic ketoacidosis dropped from 35% to 10% during the study period.
- Improved maternal and neonatal outcomes were observed following protocol adoption.
Conclusions:
- Aggressive management of diabetic ketoacidosis in pregnancy is effective.
- Proactive strategies can substantially reduce diabetic ketoacidosis and associated fetal morbidity and mortality.