Impact of Diabetic Ketoacidosis on Pregnancy Outcome at Al jala Hospita

Abstract

Diabetic ketoacidosis (DKA) in pregnancy is a serious complication that poses several challenges with respect to
diagnosis, management and prevention.
Aim: To identify maternal and neonatal outcomes in patients with history of diabetic ketoacidosis during the
pregnancy.
This study was a case series study. It was carried out in diabetic pregnancy unit, Al jala maternity hospital from 1st
of January 2010 to 31st of January 2017. Twenty-six diabetic pregnant women with history of DKA during period of
study were included. Data was collected in a preformed work sheet including patient`s age, parity, abortion, type of
diabetes, duration of diabetes, gestational age at booking and at DKA time, laboratory results, precipitating factors
of DKA, mode of delivery and neonatal outcome.
The mean age for DKA patients was 35±6.2 years. Most of affected patients were para 1-3, the majority of patients
had type I diabetes and they were on insulin therapy with mean duration of 9 years, the mean blood glucose level
was 356 mg/dl, the mean PH was 7.21, the mean HbA1c was 8.3%, and the mean bicarbonate level was 6.1 meq/L.
Emesis was the main precipitating factor followed by urinary tract infection(UTI) and steroid administration, 42.3%
of affected patients delivered by cesarean section (C/S) and no maternal mortality was recorded. Regarding fetal
outcomes, 34.6% had abortion, 42.3% were low birth weight, and only 7.7% were large babies, intra uterine fetal
death (IUFD) recorded in about 30.8% of the cases.
While the outcomes of diabetic ketoacidosis in pregnancy have improved over years, DKA remains an important
cause of maternal morbidity and fetal loss in diabetic pregnancy. Prevention, early recognition and hospitalization,
and aggressive intensive care unit management remain the cornerstones to minimize the adverse outcomes of this
dreaded complication