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Abstract：
BACKGROUND: Euglycaemic ketoacidosis (EKA) is an infrequent but serious condition which usually follows a period of starvation, severe vomiting or illness in individuals with or without diabetes. Ketoacidosis is associated with materno-fetal morbidity and mortality necessitating prompt diagnosis and management. Physiological increases in insulin resistance render pregnancy a diabetogenic state with increased susceptibility to ketosis. COVID-19 is associated with worse clinical outcomes in patients with diabetes and is an independent risk factor for ketoacidosis in normoglycaemic individuals.
METHODS: We describe two cases of SARS-CoV-2 positive pregnant women presenting with normoglycaemic metabolic ketoacidosis. Both cases were associated with maternal and fetal compromise, requiring aggressive fluid and insulin resuscitation and early delivery.
CONCLUSIONS: We discuss possible physiology and propose a management strategy for euglycaemic ketoacidosis in pregnancy.
METHODS: We describe two cases of SARS-CoV-2 positive pregnant women presenting with normoglycaemic metabolic ketoacidosis. Both cases were associated with maternal and fetal compromise, requiring aggressive fluid and insulin resuscitation and early delivery.
CONCLUSIONS: We discuss possible physiology and propose a management strategy for euglycaemic ketoacidosis in pregnancy.
摘要：
背景：优糖血症性酮症酸中毒（EKA）是一种罕见但严重的疾病，通常在饥饿后一段时间，患有或不患有糖尿病的人出现严重呕吐或疾病。酮症酸中毒与母胎发病率和死亡率相关，需要及时诊断和治疗。胰岛素抵抗的生理增加使妊娠成为糖尿病状态，对酮症的易感性增加。COVID-19与糖尿病患者临床预后较差相关，是血糖正常个体酮症酸中毒的独立危险因素。
方法：我们描述了2例SARS-CoV-2阳性孕妇，表现为血糖正常的代谢性酮症酸中毒。这两种情况都与母体和胎儿的妥协有关，需要积极的液体和胰岛素复苏和早期分娩。
结论：我们讨论了妊娠期正常血糖性酮症酸中毒的可能生理学，并提出了治疗策略。
方法：我们描述了2例SARS-CoV-2阳性孕妇，表现为血糖正常的代谢性酮症酸中毒。这两种情况都与母体和胎儿的妥协有关，需要积极的液体和胰岛素复苏和早期分娩。
结论：我们讨论了妊娠期正常血糖性酮症酸中毒的可能生理学，并提出了治疗策略。
