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Starvation Ketosis Pregnancy

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Starvation Ketoacidosis In Pregnancy

Introduction: Starvation ketosis outside pregnancy is a rare phenomenon and is unlikely to cause a severe acidosis. Pregnancy is an insulin resistant state due to placental production of hormones including glucagon and human placental lactogen. Insulin resistance increases with advancing gestation and this confers a susceptibility to ketosis, particularly in the third trimester. Starvation ketoacidosis in pregnancy has been reported and is usually precipitated by a period of severe vomiting. Ketoacidosis has been associated with intrauterine death. Case report: A 22-year-old woman in her third pregnancy presented at 32 weeks gestation with a 24 h history of severe vomiting. She had been treated for an asthma exacerbation with prednisolone and erythromycin the day prior to presentation. She was unwell, hypertensive (145/70 mmHg) with a sinus tachycardia and Kussmaul breathing. Urinalysis showed ++++ ketones, + protein and pH 5. Fingerprick glucose was 4 mmol/l and ketones were 4.0 mmol/l. Arterial blood gas showed pH 7.27, PaCO2 1.1 kPa, base excess −23, bicarbonate 8.6 mmol/l and lactate 0.6 mmol/l. The anion gap was 20. Serum ethanol, salicylates and paracetamol levels were unde Continue reading >>

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Popular Questions

  1. MrsNoMohren

    So I went to my 14 week check up today and I was having my typical morning sickness but maybe a little bit worse (riding in a car makes it worse and my doctor is a hr drive away). Well when I got in there they freaked out at me puking because they thought I had the flu (I thought they were about to call in hazmat!) but when I told them it was just my normal situation they started asking me question really concerned. I started to feel dumb that I hadn't worried more about how sick I had been but from being on here, reading up, and having preggie buddies that are sick I thought I was normal. Well they ran a bunch of tests on me and hooked me up to 2 bags of IV fluids. I was pretty scared at this point as I felt like the whole office was coming in to look at me. Well I'm 5'8 and was 208 at 3 weeks (the highest I had ever been due to endo flare ups that I was hoping to get down before I conceived. didn't happen). Well today I was down to 192 and they freaked out about that to which I just figured it was because I had been sick and my endo was gone. Well then they told me I have starvation ketosis because I had extremely high level of ketones in my urine. They said all my other vitals looked good and that starvation ketosis is basically like malnutrition and its probably because I haven't been able to eat enough due to feeling sick. They told me my baby had a strong heartbeat and was fine- not to worry because baby will get the first of everything.
    Now, I've gotten home, told my family and they're being SO MEAN about it. Saying how could I possibly be starving if I look like a do (ill attach a photo to prove I'm not a beached whale or anything! geewhiz!) and that they think my doctor is blowing this out of proportion. It hurts to feel like they aren't taking this serious and even making fun of me in the process. THEN I made the mistake of googling the situation and it said that high levels of ketones CAN hurt the baby- even lowering their IQ. I know this sounds ridiculous but this is something that really bothers me because my husband is a Dr. of Mechanical Engineering and in Mensa and I feel like I'm carrying this baby that has a chance to really make an impact and I'm screwing it up! I just want to know why the doctor didn't tell me that this situation is dangerous to baby. I just feel so alone and was hoping there is someone out there that may know more info on this on a personal level.
    Below: me at my current state

  2. Augie

    AWWWW. Family can be SO mean sometimes!!! I know it's SO hard, but try not to worry about the baby. I'm sure that everything will be just fine.

  3. MeowPurr32

    You are stunning and I don't think it's possible you weight anywhere near 192 lbs.? (Confused.) You don't look like it at ALL; you look amazing! Your family must not understand the serious nature of what you told them. I hope you can find some support from at least one or two of them. Anyone with a medical background in your family or group of friends who you can talk to? Perhaps they just need to be more educated about it. You could print out information for them to read. I'd tell them they hurt my feelings, and explain why, and give them the information. Glad you're getting good medical care now. Don't worry about those who aren't supportive, hon. Focus on your health and your baby.

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