[妊娠期正常血糖性糖尿病酮症酸中毒]

[Euglycemic diabetic ketoacidosis during pregnancy].

作者信息

Kamphof Hester D, De Smet Vivienne, Jansen Nicoline E, Tjan Dave H T, Heijligenberg Rik

机构信息

Ziekenhuis Gelderse Vallei, afd. Gynaecologie, Ede.

Contact: Hester D. Kamphof (

出版信息

Ned Tijdschr Geneeskd. 2021 Apr 29;165:D5238.

PMID:34346591

Abstract

BACKGROUND

Diabetic ketoacidosis (DKA) can have an atypical presentation during pregnancy. In the case of euglycemic DKA, relatively normal blood glucose levels can hinder a quick diagnosis.

CASE DESCRIPTION

A 34-year-old DM1 patient, 31 weeks pregnant, was admitted because of reduced fetal movements and nausea. She had reduced the amount of insulin that her insulin pump administered and had a severe euglycemic DKA. The CTG was abnormal and there was a threat of preterm birth. She was treated with insulin, glucose and bicarbonate. A month later the patient underwent an emergency cesarean section because of an abnormal CTG. A daughter was born that weighed 4820 grams, the Apgar score was 5/8/8, and the pH was 7.14. The girl required intravenous glucose for a week.

CONCLUSION

Euglycemic DKA during pregnancy requires swift recognition and treatment but this remains challenging.

摘要

背景

糖尿病酮症酸中毒（DKA）在孕期可能有非典型表现。在血糖正常的DKA病例中，相对正常的血糖水平会妨碍快速诊断。

病例描述

一名34岁的1型糖尿病患者，孕31周，因胎动减少和恶心入院。她减少了胰岛素泵输注的胰岛素量，发生了严重的血糖正常的DKA。胎儿电子监护（CTG）异常，存在早产风险。她接受了胰岛素、葡萄糖和碳酸氢盐治疗。一个月后，由于CTG异常，患者接受了急诊剖宫产。一名女婴出生，体重4820克，阿氏评分5/8/8，pH值为7.14。该女婴需要静脉输注葡萄糖一周。