BMJ Case Reports 2018; doi:10.1136/bcr-2017-221325
  • Reminder of important clinical lesson

Resolution of severe fetal distress following treatment of maternal diabetic ketoacidosis

  1. Hak Koon Tan
  1. Singapore General Hospital, Singapore
  1. Correspondence to Dr Yang Huang Grace Ng, grace.ng4{at}
  • Accepted 10 February 2018
  • Published 9 March 2018


Diabetic ketoacidosis (DKA) during pregnancy is a serious metabolic complication of diabetes with high mortality and morbidity if not detected and treated immediately. We report a case of a woman with type 1 diabetes mellitus who had poorly controlled diabetes in the first half of pregnancy and developed DKA at 29 weeks gestation. At presentation, she had a pathological fetal heart tracing but delivery was delayed for maternal stabilisation and reversal of acidosis. Once hyperglycaemia, acidosis and maternal stabilisation were achieved, fetal compromise resolved and delivery was no longer indicated. The patient was subsequently discharged home. She delivered vaginally a 2400 g baby at 34 weeks gestation after presenting with spontaneous rupture of membranes.


  • Contributors YHGN wrote the case report and obtained patient consent. TXE edited the case report. DK made a substantial involvement in the case and revision of the case report. HKT served as the primary doctor of the patient and played a substantial role in conceptualising the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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