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Diabetic Ketoacidosis and Pregnancy

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Obstetric Catastrophes

Abstract

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HSH) are acute metabolic complications of diabetes mellitus that can occur in patients with type 1 and type 2 diabetes. Timely diagnosis, clinical and internal biochemical evaluation, and effective management are important for the successful resolution of these complications. Management includes admission to the intensive care unit, resuscitation with fluids, insulin therapy, electrolyte replacement, with continuous maternal and fetal monitoring (Kitabchi et al. Cuidado de la diabetes 29:2739–2748, 2006).

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Angel, NT.M., Ibeth, FC.M., Antonio, HP.J. (2021). Diabetic Ketoacidosis and Pregnancy. In: Montufar, C., Hidalgo, J., Gei, A.F. (eds) Obstetric Catastrophes. Springer, Cham. https://doi.org/10.1007/978-3-030-70034-8_10

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  • DOI: https://doi.org/10.1007/978-3-030-70034-8_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-70033-1

  • Online ISBN: 978-3-030-70034-8

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