Diabetic ketoacidosis complicating pregnancy.
OBJECTIVE
This report describes the physiologic alterations that predispose pregnant women to diabetic ketoacidosis and the experience in a tertiary center after adoption of aggressive management of diabetics.


METHODS
In 1982 a protocol for strict surveillance of glucose homeostasis for pregnant diabetic patients and the early recognition and aggressive treatment of patients who do have diabetic ketoacidosis was initiated and has resulted in improved maternal and neonatal outcomes.


RESULTS
From 1986 through 1991 the incidence of diabetic ketoacidosis was 3% compared with an incidence of 22% from 1976 to 1981. During this same time the incidence of fetal death associated with diabetic ketoacidosis decreased from 35% to 10%.


CONCLUSIONS
Diabetic ketoacidosis and fetal morbidity/mortality can be reduced by aggressive management during pregnancy.
Chauhan
S P
SP
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Perry
K G
KG
McLaughlin
B N
BN
Roberts
W E
WE
Sullivan
C A
CA
Morrison
J C
JC
D000328:Adult; D016883:Diabetic Ketoacidosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005313:Fetal Death / Q000517:prevention & control*; D006801:Humans; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors