Cullen M T, Reece E A, Homko C J, Sivan E
Department of Obstetrics and Gynecology at Yale University School of Medicine, New Haven, Connecticut, USA.
Am J Perinatol. 1996 Oct;13(7):449-51. doi: 10.1055/s-2007-994386.
The purpose of the present study was to examine the presentation and outcomes associated with diabetic ketoacidosis (DKA) in pregnancies complicated by diabetes. Eleven episodes (2%) of DKA were diagnosed during the 10-year study period. All patients were under close observation by the Diabetes-in-Pregnancy Service. Plasma glucose levels of less than 200 mg/dL were present in 4 of the 11 patients (36%), 10 (90%) of whom presented with nausea, vomiting, and decreased caloric intake. Two subsequently had fetal distress necessitating cesarean section. One fetal death occurred in a patient treated with subcutaneous insulin. Despite contemporary methods of diabetes care, near-normal plasma glucose levels are not enough to preclude diabetic ketoacidosis. Nausea, vomiting, and decreased caloric intake in an otherwise normal pregnant, diabetic woman requires evaluation to exclude ketosis.
本研究的目的是检查糖尿病合并妊娠时糖尿病酮症酸中毒（DKA）的表现及结局。在为期10年的研究期间诊断出11例（2%）DKA发作。所有患者均由妊娠糖尿病服务机构密切观察。11例患者中有4例（36%）血浆葡萄糖水平低于200mg/dL，其中10例（90%）出现恶心、呕吐和热量摄入减少。2例随后出现胎儿窘迫，需要剖宫产。1例接受皮下胰岛素治疗的患者发生胎儿死亡。尽管有当代糖尿病护理方法，但接近正常的血浆葡萄糖水平不足以预防糖尿病酮症酸中毒。正常妊娠糖尿病女性出现恶心、呕吐和热量摄入减少需要进行评估以排除酮症。
