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ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Born during Maternal Ketoacidosis; Recognition of Neonatal Consequences

Lauren C Weeke* and Van Straaten HLM
Department of Neonatology, Isala Clinics, Zwolle, The Netherlands
Corresponding Author : Lauren C Weeke, MD
Isala Clinics, Neonatology
P.O. Box 104008000
GK Zwolle, The Netherlands
Tel: +31-38-4245055
Fax: +31-38-4247667
E-mail: [email protected]
Received August 10, 2012; Accepted August 25, 2012; Published August 27, 2012
Citation: Weeke LC, Van Straaten HLM (2012) Born during Maternal Ketoacidosis; Recognition of Neonatal Consequences. J Clin Case Rep 2:191. doi:10.4172/2165-7920.1000191
Copyright: © 2012 Weeke LC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

After peripartum asphyxia, metabolic acidosis and neurological derangement are clinical findings. In severe cases, treatment with hypothermia should be started within six hours after birth. A rare cause of neonatal metabolic acidosis is maternal metabolic derangement due to Diabetic Keto Acidosis (DKA). We report characteristics of a boy born at 336/7 weeks gestation to a mother with unrecognized DKA in gestational diabetes mellitus. Persistent metabolic acidosis and severe neurological derangement resulted. Diagnosed as severe peripartum asphyxia, hypothermia was started. Hours after delivery, the mother was diagnosed with DKA. Although the child’s diagnosis of peripartum asphyxia was revised, hypothermia was continued. In newborns with severe metabolic acidosis and normal serum lactate, maternal metabolic derangement due to DKA should be considered. In those cases hypothermia is not proven effective. Early recognition and treatment of maternal DKA potentially prevents fetal death, neonatal sequelae and in less severe cases, unnecessary invasive hypothermic therapy.

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