Diabetic Ketoacidosis (DKA) is a serious medical and obsteric emergency which usually occurs in women with type 1 diabetes. DKA is an infrequent complication of gesational diabetes (GDM) which compromises both the fetus and the mother in the later stages of pregnancy and can result in fetal loss. The metabolic changes occuring during pregnancy, can predispose a pregnant woman with GDM to DKA. This diagnosis of DKA can be more challenging during pregnancy as it does not always manifest with the classic presenting symptoms or laboratory findings. Although uncommon during pregnancy, DKA may develop even in the setting of relative normoglycaemia. Prompt diagnosis and management is essential in order to optimise maternal and fetal outcomes.
This year at King Edward Memorial Hospital (KEMH), there has been three woman diagnosed with GDM diagnosed with DKA in pregnancy. All three woman had different contributing factors. Two of the three woman were given prophylactic corticosteroids for fetal lung maturity as delivery was thought to be imminent and the third presented with infection.
A discussion of the precipitation factors to DKA will be outlined for each of the three women in this poster.