Management of diabetic ketoacidosis in the obstetric patient.

Because of the normal metabolic changes found in pregnancy, diabetics are at increased risk to develop ketoacidosis. Even though the incidence of DKA during pregnancy has declined in recent years, prompt recognition of the presenting signs and symptoms followed by appropriate treatment of the associated metabolic disturbances can be lifesaving to the mother and her unborn child. Therapy is directed toward aggressive fluid resuscitation, avoidance of hypokalemia, and reversal of the hyperglycemia and ketoacidosis. When the clinician is confronted with DKA in the obstetric patient, aggressive therapeutic measures should maximize maternal and fetal outcome.