Diabetic ketoacidosis in pregnancy – Case series, pathophysiology, and review of the literature

Tamar Eshkoli, Leonid Barski, Yaniv Faingelernt, Alan Jotkowitz, Alona Finkel-Oron, Dan Schwarzfuchs

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: Diabetic ketoacidosis (DKA) during pregnancy is a life-threatening emergency for both the mother and the fetus. The pathophysiology of DKA in pregnancy has its own characteristics due to multiple factors, such as insulin resistance, accelerated starvation and respiratory alkalosis, thus creating ketosis-prone state, with DKA occurring at milder degrees of hyperglycemia, even in normoglycemic levels, which can result in delayed diagnosis and treatment with potential for adverse metabolic consequences. Study design: In this article, we presented 8 clinical cases of DKA during pregnancy. We discuss the spectrum of the clinical picture, the entity of euglycemic DKA vs hyperglycemic DKA, the period of pregnancy in appearance of episode of DKA and triggers of DKA. Conclusion: The treatment of DKA in pregnant women must be started immediately and must be accentuated on intravenous fluids, insulin and electrolyte replacement. DKA in pregnancy may be euglycemic. Prevention, early recognition, immediate hospitalization, and aggressive management remain the cornerstones in DKA management in pregnancy.

Original languageEnglish
Pages (from-to)41-46
Number of pages6
JournalEuropean Journal of Obstetrics, Gynecology and Reproductive Biology
Volume269
DOIs
StatePublished - 1 Feb 2022
Externally publishedYes

Keywords

  • DKA management
  • DKA pregnancy
  • Euglycemic DKA

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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