Endocrine Emergencies During Pregnancy: Diabetic Ketoacidosis and Thyroid Storm

Obstet Gynecol Clin North Am. 2022 Sep;49(3):473-489. doi: 10.1016/j.ogc.2022.02.003.

Abstract

The physiologic changes and common signs and symptoms of pregnancy can make the early recognition of endocrine emergencies more challenging. Diabetic ketoacidosis (DKA) can occur at only modestly elevated glucose levels (euglycemic DKA), often accompanied by starvation ketosis due to substantial fetal-placental glucose demands and is associated with a high stillbirth rate. Thyroid storm is life threatening with a higher rate of heart failure and both require prompt and aggressive treatment to avoid maternal and fetal morbidity and mortality. Treatment of these disorders and the special considerations for recognition and management in the context of pregnancy are reviewed.

Keywords: Diabetic ketoacidosis; Endocrine emergencies; Euglycemic diabetic ketoacidosis; Pregnancy; Thyroid storm.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus*
  • Diabetic Ketoacidosis* / complications
  • Diabetic Ketoacidosis* / diagnosis
  • Diabetic Ketoacidosis* / therapy
  • Emergencies
  • Female
  • Glucose
  • Humans
  • Placenta
  • Pregnancy
  • Thyroid Crisis* / complications
  • Thyroid Crisis* / diagnosis
  • Thyroid Crisis* / therapy

Substances

  • Glucose