tetano
Editor, Senior Moderator
Cureus
. 2022 Jan 26;14(1):e21649.
doi: 10.7759/cureus.21649. eCollection 2022 Jan.
Euglycemic Diabetic Ketoacidosis in a Pregnant Woman With Severe COVID-19: A Case Report
Megan L Harman[SUP] 1 [/SUP], Emery M Cuellar[SUP] 1 [/SUP], Allyson R Burkhart Denora[SUP] 2 [/SUP], Megha Pokhriyal[SUP] 1 [/SUP], Saad Mussarat[SUP] 1 [/SUP]
Affiliations
Abstract
Euglycemic diabetic ketoacidosis (DKA) of pregnancy is an uncommon but serious condition that poses a substantial risk to the fetus. The physiological state of pregnancy itself predisposes women to ketosis and ketoacidosis, which can be further exacerbated by acute stressors such as infection. In this article, we describe a case of a pregnant woman with gestational diabetes and coronavirus disease 2019 (COVID-19) requiring mechanical ventilation who developed euglycemic DKA during her hospital course. Despite treating the patient with standard DKA protocol, fetal heart monitoring was non-reassuring and, hence, a cesarean section was performed. Postoperatively, her DKA resolved; however, she was maintained on supportive ventilation for continued management of her severe COVID-19 infection. In light of the ongoing pandemic, it is essential that healthcare teams closely monitor pregnant women presenting with COVID-19 infection for early signs of euglycemic DKA so that treatment may be initiated early and feto-maternal complications are avoided.
Keywords: covid-19; diabetic ketoacidosis; euglycemic; hypoxemic respiratory failure; pregnancy.
. 2022 Jan 26;14(1):e21649.
doi: 10.7759/cureus.21649. eCollection 2022 Jan.
Euglycemic Diabetic Ketoacidosis in a Pregnant Woman With Severe COVID-19: A Case Report
Megan L Harman[SUP] 1 [/SUP], Emery M Cuellar[SUP] 1 [/SUP], Allyson R Burkhart Denora[SUP] 2 [/SUP], Megha Pokhriyal[SUP] 1 [/SUP], Saad Mussarat[SUP] 1 [/SUP]
Affiliations
- PMID: 35242454
- PMCID: PMC8884461
- DOI: 10.7759/cureus.21649
Abstract
Euglycemic diabetic ketoacidosis (DKA) of pregnancy is an uncommon but serious condition that poses a substantial risk to the fetus. The physiological state of pregnancy itself predisposes women to ketosis and ketoacidosis, which can be further exacerbated by acute stressors such as infection. In this article, we describe a case of a pregnant woman with gestational diabetes and coronavirus disease 2019 (COVID-19) requiring mechanical ventilation who developed euglycemic DKA during her hospital course. Despite treating the patient with standard DKA protocol, fetal heart monitoring was non-reassuring and, hence, a cesarean section was performed. Postoperatively, her DKA resolved; however, she was maintained on supportive ventilation for continued management of her severe COVID-19 infection. In light of the ongoing pandemic, it is essential that healthcare teams closely monitor pregnant women presenting with COVID-19 infection for early signs of euglycemic DKA so that treatment may be initiated early and feto-maternal complications are avoided.
Keywords: covid-19; diabetic ketoacidosis; euglycemic; hypoxemic respiratory failure; pregnancy.