Priya Vishnu, Ninave Sanjot, Sen Jayshree, Bele Amol
Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2023 Dec 23;15(12):e51014. doi: 10.7759/cureus.51014. eCollection 2023 Dec.
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus that poses unique challenges during pregnancy. We present a case of a 36-year-old pregnant woman with a history of type 1 diabetes mellitus who developed severe DKA at 33.5 weeks of gestation, necessitating an emergency cesarean section. Despite a known history of diabetes, the patient's infrequent clinic attendance and suboptimal disease management contributed to her critical condition. DKA was promptly diagnosed, and a multidisciplinary team comprising obstetricians, endocrinologists, anesthesiologists, and neonatologists collaborated to provide comprehensive care. The preoperative assessment revealed dehydration and electrolyte imbalances, necessitating meticulous planning for IV fluid administration and hemodynamic stability during the cesarean section. Regional anaesthesia was chosen as the anaesthetic approach, and close postoperative monitoring was initiated. The neonate, delivered with satisfactory Apgar scores, was transferred to the neonatal ICU for observation. The patient's gradual clinical improvement over 48 hours demonstrated the importance of ongoing care. This case highlights the significance of early recognition, multidisciplinary teamwork, and meticulous perioperative care in managing DKA during pregnancy, ensuring favourable outcomes for both the mother and the neonate.
糖尿病酮症酸中毒(DKA)是糖尿病的一种危及生命的并发症,在孕期会带来独特的挑战。我们报告一例36岁的孕妇,她有1型糖尿病病史,在妊娠33.5周时发生了严重的DKA,需要紧急剖宫产。尽管患者有糖尿病病史,但她不经常就诊且疾病管理欠佳,导致了她的危急状况。DKA被迅速诊断出来,一个由产科医生、内分泌科医生、麻醉科医生和新生儿科医生组成的多学科团队合作提供全面护理。术前评估发现脱水和电解质失衡,因此在剖宫产期间需要精心规划静脉输液管理和血流动力学稳定。选择区域麻醉作为麻醉方法,并在术后开始密切监测。新生儿出生时阿氏评分令人满意,被转至新生儿重症监护病房观察。患者在48小时内逐渐临床好转,这表明持续护理的重要性。该病例强调了早期识别、多学科团队合作以及在孕期管理DKA时精心的围手术期护理的重要性,以确保母亲和新生儿都能获得良好的结局。