Cetoacidosis diabética normoglicémica en el embarazo. Caso clínico
Author
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Rivas Muñoz, Margarita
Author
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Belmar Zagal, Claudia
Author
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Durruty Alfonso, Pilar
Author
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Sanhueza, Lilian
Author
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López Stewart, Gloria
Admission date
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2017-12-07T15:35:54Z
Available date
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2017-12-07T15:35:54Z
Publication date
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2016
Cita de ítem
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Rev Med Chile 2016; 144: 1360-1364
es_ES
Identifier
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0034-9887
Identifier
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https://repositorio.uchile.cl/handle/2250/146074
Abstract
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Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8. Fetal maturation was initiated. Laboratory tests showed a metabolic acidosis, a low pH, an increased Gap anion, elevated ketonemia and a blood glucose of 172 mg/dl. A diagnosis of normoglycemic diabetic ketoacidosis was formulated and treatment with hydration and regular insulin according to capillary blood glucose levels was started. An emergency caesarean section was performed. The newborn weighed 2.650 kg, had a length of 46 cm, was large for gestational age, had an Apgar score of 2.7, had perinatal asphyxia, convulsive syndrome and a possible congenital cardiopathy. Once the ketoacidosis was resolved during the immediate puerperium, slow acting insulin was initiated