Acute starvation in pregnancy: a cause of severe metabolic acidosis.

Abstract:

:We report a case of starvation-induced metabolic ketoacidosis in a previously healthy 29-year-old, nulliparous woman at 32 weeks of gestation. She was admitted to hospital with mild preeclampsia associated with persistent nausea and vomiting that progressed to severe preeclampsia requiring urgent control of hypertension before caesarean delivery. Prolonged and severe vomiting limited oral caloric intake and led to starvation ketoacidosis, characterised by ketonuria and a raised anion gap metabolic acidosis that required intensive care support. Despite significant metabolic derangement the patient appeared clinically well. Intravascular volume was replenished. Fluid restriction used as part of our preeclampsia treatment regimen delayed the therapeutic administration of sufficient dextrose, which rapidly corrected her metabolic derangement when commenced after delivery. Electrolyte supplementation was given to prevent re-feeding syndrome. Both mother and baby were discharged without sequelae.

journal_name

Int J Obstet Anesth

authors

Patel A,Felstead D,Doraiswami M,Stocks GM,Waheed U

doi

10.1016/j.ijoa.2010.11.004

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

253-6

issue

3

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(10)00185-8

journal_volume

20

pub_type

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