Diabetic ketoacidosis complicating gestational diabetes mellitus: A case report

Abstract

The development of diabetic ketoacidosis (DKA) in pregnancy is a medical emergency that demands prompt recognition and aggressive treatment to prevent adverse fetal outcome. The occurrence of diabetic ketoacidosis as the first manifestation of gestational diabetes (GDM) is rare but is associated with a high fetal mortality rate. Early detection and prompt treatment of DKA in pregnancy usually results in successful fetal outcome. Prevention of DKA can be achieved by pre-conception counseling, screening of at-risk women during antenatal booking, and clinic. This report is that of GDM complicated by severe DKA at 18 week of gestation. DKA was successfully treated with soluble insulin and normal saline. Patient was followed up as an outpatient. She delivered a live healthy baby boy at term with no abnormality. Pre-conception counseling and early antenatal booking is advocated in order to avoid delayed diagnoses and possible fetal losses.