{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T13:39:40Z","timestamp":1794317980781,"version":"4.9.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010six records of pregnancies that were complicated with DKA over a 10\u2010year period were reviewed. Mean age was 29.6\u00a0years (range 20\u201343\u00a0years). Thirty\u2010six (64.3%) women had type 1 diabetes mellitus. DKA was categorized into mild (<jats:italic>n<\/jats:italic>\u00a0=\u00a026, 46.4%), moderate (<jats:italic>n<\/jats:italic>\u00a0=\u00a022, 39.3%), and severe (<jats:italic>n<\/jats:italic>\u00a0=\u00a08, 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 &lt;7.0) demonstrated adverse perinatal outcomes (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite the availability of guidelines, DKA is sub\u2010optimally managed in pregnancy, which may contribute to adverse maternal and perinatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14093","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T01:38:31Z","timestamp":1641605911000},"page":"557-563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A 10\u2010year audit of pregnancies affected by diabetic ketoacidosis at the Pretoria Academic Complex"],"prefix":"10.1002","volume":"158","author":[{"given":"Ncamsile F.","family":"Maseko","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danie","family":"van Zyl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Pretoria Diabetes Research Centre Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumaiya","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Pretoria Diabetes Research Centre Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/20786204.2008.10873664"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3233\/NPM\u20101663"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000060"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.79.934.454"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2013.04.005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102007\u2010994386"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000183164.69315.13"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0889\u20108545(05)70092\u20109"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.108744"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447\u20100756.2008.00720.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2018.v108i8.13082"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06\u20109916"},{"issue":"1","key":"e_1_2_8_14_1","first-page":"S1","article-title":"The 2017 SEMDSA Guideline for the Management of Type 2 Diabetes Guideline Committee","volume":"21","author":"The Society for Endocrinology, Metabolism and Diabetes of South Africa Type 2 Diabetes Guidelines Expert Committee","year":"2017","journal-title":"JEMDSA"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/11795514211004957"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.4314\/eamj.v82i12.9382"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v10i1.1612"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2019.v109i6.13700"},{"key":"e_1_2_8_19_1","unstructured":"AbungaDK. 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