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Clinical Management of Diabetic Ketoacidosis in Pregnancy: A Review of Current Literature

DOI: 10.4236/oalib.1112246, PP. 1-25

Subject Areas: Emergency & Critical Care, Diabetes & Endocrinology

Keywords: Management, Diabetes, Diabetic Ketoacidosis, Pregnancy

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Abstract

Background: Diabetic ketoacidosis (DKA) in pregnancy is a life-threatening condition for both the mother and the fetus. This condition is often associated with type 1 diabetes, but it can also complicate type 2 diabetes and rarely complicates gestational diabetes. DKA in pregnancy often occurs in the 3rd trimester of pregnancy and its prevalence is worryingly increasing. Timely diagnosis and appropriate management of DKA are crucial to decreasing the maternal-fetal complications associated with that condition. As DKA in pregnancy is still poorly understood, it is important to increase awareness of healthcare professionals on this condition for its quick diagnosis and appropriate management. This narrative overview aimed to highlight the cornerstones of the management of DKA in pregnancy. Objective: The objective of this research was to review and report the current literature on the management of DKA in pregnancy. Methods: A search of the literature on the management of DKA in pregnancy was conducted through PubMed, Google Scholar, and HINARI. This narrative overview included only abstracts and articles written in English, and published between January 2003 and January 2023. This study focused on the review of the general measures, the use of fluids, the use of electrolytes, and the use of insulin in the management of DKA in pregnancy. Results: Appropriate management of pregnant women with DKA should include their admission to high dependency unit, IV fluids, electrolyte replacement, insulin therapy, management of precipitating factors, and monitoring of maternal-fetal response to treatment. Supplemental oxygen and bicarbonate may be indicated and placement of the pregnant patient in the left lateral position is crucial to avoid aortocaval compression. Conclusions: The timely diagnosis of DKA in pregnancy requires a high index of suspicion of that condition. Appropriate management of DKA in pregnancy includes fluid replacement, correction of electrolyte abnormalities, insulin therapy, management of triggers, and monitoring of maternal-fetal response to treatment.

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Noë and Niyondiko, L. (2024). Clinical Management of Diabetic Ketoacidosis in Pregnancy: A Review of Current Literature. Open Access Library Journal, 11, e2246. doi: http://dx.doi.org/10.4236/oalib.1112246.

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