Anesthetic Management of a Parturient With Diabetic Keto-Acidosis

Diabetic ketoacidosis (DKA) in pregnancy is a life threatening medical emergency. It can compromise both the fetus and the mother profoundly. The incidence of DKA during pregnancy ranges between 2 to 3%, and carries a 10?20% risk of fetal death.1 DKA is characterized by a biochemical triad of ketonemia, hyperglycemia and acidemia. We present a case of a parturient with mismanaged DKA that was brought to the operating room for a STAT cesarean section (C/S) due to fetal distress and discuss the anesthetic implications.