A 10-year audit of pregnancies affected by diabetic ketoacidosis at the Pretoria Academic Complex

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dc.contributor.author Maseko, Ncamsile F.
dc.contributor.author Van Zyl, Danie G.
dc.contributor.author Adam, Sumaiya
dc.date.accessioned 2022-08-03T05:46:49Z
dc.date.issued 2022-09
dc.description.abstract BACKGROUND : Diabetic ketoacidosis (DKA) during pregnancy is associated with increased rates of maternal and perinatal mortality and morbidity. DKA management guidelines are designed to ensure optimal management and minimize adverse outcomes. OBJECTIVE : To determine the level of adherence to DKA management guidelines at a tertiary center in Pretoria, South Africa and report on maternal and perinatal outcomes of the pregnancies complicated by DKA. METHODS : This was a retrospective clinical record audit using the Society for Endocrinology, Metabolism and Diabetes of South Africa guidelines against documented management. Adherence to three cornerstones of therapy was measured: intravenous fluids, insulin therapy, and management of electrolytes. RESULTS : Fifty-six records of pregnancies that were complicated with DKA over a 10-year period were reviewed. Mean age was 29.6 years (range 20–43 years). Thirty-six (64.3%) women had type 1 diabetes mellitus. DKA was categorized into mild (n = 26, 46.4%), moderate (n = 22, 39.3%), and severe (n = 8, 14.3%). The study demonstrated lack of adherence to the three cornerstones of therapy. Of the 49 (85.7%) women with recorded perinatal outcomes, 30.6% had stillbirths. Severe maternal DKA (pH <7.0) demonstrated adverse perinatal outcomes (P = 0.005). CONCLUSION : Despite the availability of guidelines, DKA is sub-optimally managed in pregnancy, which may contribute to adverse maternal and perinatal outcomes. en_US
dc.description.department Internal Medicine en_US
dc.description.department Obstetrics and Gynaecology en_US
dc.description.embargo 2023-01-07
dc.description.librarian hj2022 en_US
dc.description.uri http://www.wileyonlinelibrary.com/journal/ijgo en_US
dc.identifier.citation Maseko, N.F., Van Zyl, D. & Adam, S. A 10-year audit of pregnancies affected by diabetic ketoacidosis at the Pretoria Academic Complex. International Journal of Gynecology and Obstetrics 2022, vol. 158, no. 3, pp. 557-563. doi:10.1002/ijgo.14093. en_US
dc.identifier.issn 0020-7292 (print)
dc.identifier.issn 1879-3479 (online)
dc.identifier.other 10.1002/ijgo.14093
dc.identifier.uri https://repository.up.ac.za/handle/2263/86659
dc.language.iso en en_US
dc.publisher Wiley en_US
dc.rights © 2022 International Federation of Gynecology and Obstetrics. This is the pre-peer reviewed version of the following article : 10-year audit of pregnancies affected by diabetic ketoacidosis at the Pretoria Academic Complex. International Journal of Gynecology and Obstetrics 2022, vol. 158, no. 3, pp. 557-563. doi:10.1002/ijgo.14093. The definite version is available at : http://wileyonlinelibrary.com/journal/ijgo. en_US
dc.subject Diabetic ketoacidosis (DKA) en_US
dc.subject Perinatal outcome en_US
dc.subject Pregnancy en_US
dc.title A 10-year audit of pregnancies affected by diabetic ketoacidosis at the Pretoria Academic Complex en_US
dc.type Postprint Article en_US


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