Retrospective Analysis of Diabetic Ketoacidosis in Pregnant Women over a Period of 3 Years

Baagar, Khaled; Aboudi, Aida K; Khaldi, Heba; Alowinati, Buthaina; Abou‐Samra, Abdul Badi; Lindow, Stephen W.

doi:10.4172/2161-1017.1000265

Cited by 5 publications

(9 citation statements)

References 19 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Factors that predispose the pregnant women to [15] at 31 weeks of POG to a 23 year old woman G3 P2. 5% fetal mortality rate have been reported by Baagar KA (2017) [17] in their 3 year retrospective study on analysis of diabetic ketoacidosis in pregnant women.…”

Section: Discussionmentioning

confidence: 86%

Diabetic Ketoacidosis in Pregnancy: A Rare but Serious Threat to Mother and Fetus

Malik¹,

Sheikh²

2020

Act Sci wom hea

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 86%

Diabetic Ketoacidosis in Pregnancy: A Rare but Serious Threat to Mother and Fetus

Malik¹,

Sheikh²

2020

Act Sci wom hea

View full text Add to dashboard Cite

“…The likely mechanism of DKA in Pregnancy presenting glucose levels that may not be as high as the non-pregnant DKA state includes the accelerated glucose usage of fetoplacental component [2,4]. There…”

Section: Discussionmentioning

confidence: 99%

“…Open Access Journal is also an increased glycosuria, due to increased renal blood flow thus enhancing glomerular filtration without an analogous increase in tubular glucose reabsorption [2][3][4]. Other factors to explain include an enhanced maternal use of glucose due to estrogen and progesterone and its dilutional consequence from an increased plasma volume in pregnancy.…”

Section: Journal Of Diabetes Research and Therapymentioning

confidence: 99%

“…Hyperglycemia and hyperosmolarity as a consequence, results in osmotic diuresis leading to depletion of intravascular volume thus, producing poor tissue perfusion, and diminished cardiac and renal function. Maternal complications would ensue, such as, acute renal failure, adult respiratory distress syndrome, cerebral edema, coma and even, death [2][3][4]8]. During DKA in Pregnancy, the fetal brain is vulnerable to increased 3 beta hydroxyl butyrate and lactate concentrations, leading to a reduction in glucose ensuing to brain injury [3,8].…”

Section: Journal Of Diabetes Research and Therapymentioning

confidence: 99%

“…One of the serious but very rare metabolic complications is Diabetic Ketoacidosis noted in pregnancy (DKA). The incidence of DKA in pregnancy range from 0.5%, the lowest accounted rate in western countries to 8.9% in a study conducted in China [2]. Tight glycemic control is…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Case of Diabetic Ketoacidosis in Pregnancy

Kgt¹,

Gh²

2020

J Diab Res Ther

View full text Add to dashboard Cite

Objective: Diabetes has affected people worldwide across different ethnicity, gender, including the obstetric population. We report a case of a 28 year-old, multi-gravid, which has not been previously, diagnosed with diabetes in her 1 st and 2 nd pregnancy with no family history of diabetes, but developed severe Diabetic Ketoacidosis (DKA) in her third pregnancy.Case presentation: A 28 year old, Filipino, known diabetic on insulin therapy on her 24 th week age of gestation presented with dyspnea and vomiting. On admission, she was received lethargic and hypotensive with a blood pressure of 80/50 mmhg, tachycardic and tachypneic. She had muscle weakness and significant premature uterine contractions. Her random blood glucose was only 357 mg/dl (9.2 mmol/L) but was severely acidotic. Arterial Blood Gas revealed a ph of 7.036, HCO 3 of 2.6 mmol/L and PCO 2 of 9.5 mmHg, with serum ketones of 4.9 mmol/L and an anion gap of 34 mmol/L. An ultrasound of the abdomen revealed a single live, 24 weeks by fetal biometry with good cardiac and somatic activity, but with sonographic consideration of hydrops fetalis with cardiac enlargement. She was advised to have a complete prenatal diagnostic work up for which she did not comply, and came in with a critical presentation that has lead to maternal and fetal complications.Discussion: Pregnancy is a physiologic state that can lead to a significant change in metabolism. Understanding the biochemical feedback compared to the non-pregnant state is important in the diagnosis of diabetes. A serious but rare metabolic complication is DKA in Pregnancy.Our case is a rare complication of diabetes in pregnancy in the era of approved insulin analogue use. The incidence of DKA in Pregnancy range from 0.5%, the lowest accounted rate in western countries to 8.9% in a study conducted in China. The degree of hyperglycemia in pregnancy complicated by DKA does not present with significant elevation as it may be blunted due to several maternal and fetal adaptive mechanisms. Therefore, it is a diagnostic challenge because the glucose levels are either near normal or not as elevated as the non-pregnant DKA state due to the biochemical feedback. Conclusion:This case illustrates a rare but preventable complication of pregnancy. If diagnosed right away and managed properly, maternal complications can be minimized. Review of hospital records show no similar reported case in the files of Cebu Doctors' University Hospital. Our case illustrates vigilance in diagnosis as it may have long term complications both for the mother and the unborn child.

show abstract