Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 16, Number 2, February 2025, pages 87-93


A Peculiar Case of Fetal Distress Leading to the Diagnosis of Diabetic Ketoacidosis in Pregnancy

Figures

↓  Figure 1. Fetal cardiotocography of the patient at initial presentation showing reduced variability and decelerations.
Figure 1.
↓  Figure 2. Capillary blood glucose trend and intravenous insulin dose during treatment.
Figure 2.

Table

↓  Table 1. Summary of Blood Investigation Results at Initial Presentation
 
Laboratory investigations Results Reference interval
aAbnormal results. pCO2: partial pressure of CO2; pO2: partial pressure of O2.
Full blood count
  Hemoglobin, g/dL 13.2 12.0 - 16.0
  White blood cell, 109/L 7.75 4.0 - 10.0
  Platelets, 109/L 240 140 - 440
Venous blood gas (VBG) and renal panel
  pH 7.14a 7.35 - 7.45
  pCO2, mm Hg 14.6a 35.0 - 45.0
  pO2, mm Hg 63.5 80.0 - 100.0
  Sodium, mmol/L 125a 136 - 145
  Potassium, mmol/L 5.0 3.5 - 5.1
  Creatinine, mmol/L 64 49 - 90
  Urea, mmol/L 6.6 2.4 - 7.0
  Bicarbonate (HCO3), mmol/L < 5a 22 - 29
  Venous glucose, mmol/L 34.0a 3.9 - 6.0
  Chloride, mmol/L 98 98 - 107
Bone metabolism panel
  Adjusted calcium, mmol/L 2.38 2.10 - 2.55
  Phosphate, mmol/L 1.8a 0.7 - 1.5
  Magnesium, mmol/L 0.95 0.66 - 1.07
Liver function test
  Bilirubin, µmol/L 3 2 - 9
  Albumin, g/L 30 35 - 50
  Alanine transaminase, U/L 14 0 - 55
  Aspartate transaminase, U/L 15 5 - 34
  Alkaline phosphatase, U/L 108 43 - 160
  Gamma-glutamyl transferase, U/L 23 8 - 33
Lipid panel
  Total cholesterol (TC), mmol/L 6.1 Desirable < 5.2
Borderline high 5.2 - 6.1
High ≥ 6.2
  High-density lipoprotein (HDL), mmol/L 1.2 Low < 1.0
Desirable 1.0 - 1.5
High ≥ 1.6
  Low-density lipoprotein (LDL), mmol/L Invalid -
  Triglycerides (TG), mmol/L 6.5a Optimal < 2.6
Desirable 2.6 - 3.3
Borderline high 3.4 - 4.0
High 4.1 - 4.8
Very high ≥ 4.9
Others
  Ketones/beta-hydroxybutyrate (BOHB), mmol/L 3.3a 0.0 - 0.6
  Glycated hemoglobin (HbA1c), % > 14.0a
  Thyroxine, free (FT4), pmol/L 13.0 10.1 - 15.4
  Thyroid-stimulating hormone (TSH), mIU/L 0.86 0.33 - 3.33
  Procalcitonin, µg/L 0.07 < 0.09
  Troponin I, ng/L < 10 < 16
  Lactate, mmol/L 1.4 0.5 - 2.2