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.
Keywords
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Article info
Publication history
Published online: February 11, 2011
Accepted:
November 16,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
