Maternal-Fetal Medicine Obstetrics and Gynecology, Eastern Virginia Medical School, 825 Fairfax Ave, Suite 310, Norfolk, VA 23507, USA.
Semin Perinatol. 2013 Aug;37(4):267-73. doi: 10.1053/j.semperi.2013.04.005.
Diabetic ketoacidosis (DKA) is a serious medical and obstetrical emergency usually occurring in patients with type 1 (insulin-dependent) diabetes mellitus. Although modern management of the patient with diabetes should prevent the occurrence of DKA during pregnancy, this complication still occurs and can result in significant morbidity and mortality for mother and/or fetus. Metabolic changes occurring during pregnancy can predispose a pregnant diabetic to DKA. The diagnosis of DKA can be more challenging during pregnancy as it does not always manifest with the classic presenting symptoms or laboratory findings. In fact, although uncommon, during pregnancy, DKA may develop even in the setting of relative normoglycemia. Prompt diagnosis and management is essential in order to optimize maternal and fetal outcomes. This article will provide the reader with information regarding the pathophysiology underlying DKA complicating pregnancy and will provide practical management guidelines for the diagnosis and management of this condition.
糖尿病酮症酸中毒（DKA）是一种严重的医学和产科急症，通常发生在 1 型（胰岛素依赖型）糖尿病患者中。尽管现代糖尿病患者的管理应该可以预防怀孕期间 DKA 的发生，但这种并发症仍然会发生，并可能导致母婴严重的发病率和死亡率。怀孕期间发生的代谢变化可能使妊娠糖尿病患者易患 DKA。怀孕期间 DKA 的诊断可能更具挑战性，因为它并不总是表现出典型的临床表现或实验室发现。事实上，尽管不常见，但在怀孕期间，即使血糖相对正常，DKA 也可能发生。及时诊断和治疗对于优化母婴结局至关重要。本文将为读者提供有关妊娠并发 DKA 的病理生理学信息，并提供诊断和治疗这种情况的实用管理指南。
