Fatal Fetal Outcome of Diabetic Ketoacidosis in Pregnancy: A Case Report and the Review of Etiology, Pathophysiology and Management

妊娠中糖尿酮酸症併發死胎：病例報告與病因、生理病理及治療回顧

王建華(Jiann-Hwa Wang) ； 李世明(Shy-Ming Lee)

《Journal of Medical Sciences》 18卷4期 (1998/02) Pp. 260-267

摘要

糖尿酮酸症不僅是一嚴重病發症，也是妊娠中一非常緊急的代謝性急症，對產婦及胎兒皆有生命上的威脅。妊娠中糖尿酮酸症會造成極嚴重的血酸中毒，雖然此種病例是極為罕見的，以前國外也曾有少許的文獻發表。我們要報告之病例為一年輕的第二胎產婦，在沒有糖尿病的病史，卻合併嚴重代謝性酸中毒的情況下，在妊娠28週，第一次被送到本院求診時，發現已胎死腹中。所幸，我們根據產婦臨床上的症狀及徵候，立即做出正確的診斷及適切的處置才得以挽回產婦的生命。因此，對於產前有關產婦一些不正常的生理變化的衛教及假使遇到不幸的妊娠糖尿酮酸事件時，如何做好一成功完善的治療，是目前身為婦產科醫師們責無旁貸的課題。

關鍵字

糖尿酮酸症 ； 死胎

並列摘要

Diabetic ketoacidosis (DKA) is one of the severe complications and acute metabolic emergencies in obstetrics. It can jeopardize both mother and fetus. Ketoacidosis with very low serum pH in pregnancy is rare but has been described previously. Our patient was a young pregnant woman with gestational age of 28 weeks. She had no previous history of diabetes. She presented with a profound metabolic acidosis and intrauterine fetal death while she first called for help at our E.R. We immediately made accrate diagnosis and took prompt treatment according to her clinical symptoms and signs and save the mother's life, even the past history was absent. Therefore, it is the responsibility of physicians to educate the pregnant women with some abnormal physiologic changes and to learn how to make the immediate diagnosis and treatment if the unfortunate event does occur.

並列關鍵字

diabetic ketoacidosis ； intrauterine fetal death