Introduction: Diabetic ketoacidosis (DKA) in pregnancy is rare
but associated with maternal and foetal morbidity and mortality. The objectives
of this study were to evaluate the epidemiological, diagnostic, and prognostic
characteristics of DKA in pregnant women in Dakar hospitals and to study the
predictive factors of its occurrence. Methods: This retrospective study
was conducted from January 2013 to January
2021 in the Internal Medicine/Endocrinology-Diabetology-Nutrition
and Gynaecology-Obstetrics departments of the National University Hospital Centre in
Pikine, Senegal. Medical files of all pregnant women hospitalised for DKA
during this period were collected. Results: A total of 10 patients were
included in the study. Average age was 30.9 years. Two patients with unplanned
pregnancies had pre-gestational diabetes mellitus (pre-GDM) and did not have
regular diabetic follow-up. Among the 8 patients with GDM, risk factors for GDM
were found in 7 women, and three had a history of GDM. Blood glucose levels
were >1.02 and >11 g/L for these two groups, respectively. None of the
women had been systematically screened for GDM between 24 and 28 gestational
weeks. Signs of ketosis were present: 6 patients had Kussmaul dyspnea and one
patient had a Glasgow Coma Score of 10/15. The precipitating factor was
infection in three patients. Two patients had pre-eclampsia. The evolution of
DKA was favourable in all patients. For pregnancy outcomes: 4 cases of
intrauterine foetal death were recorded, 2 women carried their pregnancy to
term,a woman gives birth prematurely and 3 patients were
lost to follow-up. Conclusion: DKA during pregnancy is rare in Dakar
hospitals but health risk increases with the lack of screening for GDM in
pregnant women, follow-up in a specialised environment, and pregnancy planning
in diabetic patients. The obstetrical prognosis is poor for GDM patients, with
a high rate of foetal death in utero.
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