Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section
A 31-year-old pregnant woman ( weeks) was admitted with extreme tachypnea. She had a previous history of congenital muscular dystrophy (Ullrich’s disease) and isolated glucosuria. The patient had reduced food intake during the last 24 hours prior to admission and vomited twice. Serum glucose level w...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2013/847942 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832548357264900096 |
|---|---|
| author | Nicolas Cecere Corinne Hubinont Arnauld Kabulu Kadingi Marie-Françoise Vincent Peter Van den Bergh Anna Onnela Philippe Hantson |
| author_facet | Nicolas Cecere Corinne Hubinont Arnauld Kabulu Kadingi Marie-Françoise Vincent Peter Van den Bergh Anna Onnela Philippe Hantson |
| author_sort | Nicolas Cecere |
| collection | DOAJ |
| description | A 31-year-old pregnant woman ( weeks) was admitted with extreme tachypnea. She had a previous history of congenital muscular dystrophy (Ullrich’s disease) and isolated glucosuria. The patient had reduced food intake during the last 24 hours prior to admission and vomited twice. Serum glucose level was normal (112 mg/dL), while urinalysis revealed glucosuria 4+ and ketonuria 4+. ABG revealed pH 7.06, PCO2 9 mm Hg, and bicarbonate 2 mmol/L. Anion gap was 28 mmol/L. Tachypnea was a compensatory mechanism for a severe nonlactic metabolic acidosis. The diagnosis of starvation ketoacidosis was established. The patient received supplemental dextrose 10% intravenously and sodium bicarbonate. As fetal heart monitoring was pathological, an emergency caesarean section was performed. Umbilical cord venous pH was 7.01, with PCO2 34 mm Hg and bicarbonate 8 mmol/L. Starvation ketoacidosis is a rare metabolic disorder that may occur mainly in the third trimester of pregnancy. Muscular dystrophy and renal glucosuria were precipitating factors. |
| format | Article |
| id | doaj-art-cdcd997a27944fcfa0889ff508db3162 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-cdcd997a27944fcfa0889ff508db31622025-02-03T06:14:16ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922013-01-01201310.1155/2013/847942847942Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean SectionNicolas Cecere0Corinne Hubinont1Arnauld Kabulu Kadingi2Marie-Françoise Vincent3Peter Van den Bergh4Anna Onnela5Philippe Hantson6Department of Intensive Care, Université Catholique de Louvain, Cliniques St-Luc, Avenue Hippocrate 10, 1200 Brussels, BelgiumDepartment of Obstetrics, Université Catholique de Louvain, Cliniques St-Luc, 1200 Brussels, BelgiumDepartment of Obstetrics, Université Catholique de Louvain, Cliniques St-Luc, 1200 Brussels, BelgiumDepartment of Biochemistry, Université Catholique de Louvain, Cliniques St-Luc, 1200 Brussels, BelgiumNeuromuscular Reference Centre, Université Catholique de Louvain, Cliniques St-Luc, 1200 Brussels, BelgiumDepartment of Neonatology, Université Catholique de Louvain, Cliniques St-Luc, 1200 Brussels, BelgiumDepartment of Intensive Care, Université Catholique de Louvain, Cliniques St-Luc, Avenue Hippocrate 10, 1200 Brussels, BelgiumA 31-year-old pregnant woman ( weeks) was admitted with extreme tachypnea. She had a previous history of congenital muscular dystrophy (Ullrich’s disease) and isolated glucosuria. The patient had reduced food intake during the last 24 hours prior to admission and vomited twice. Serum glucose level was normal (112 mg/dL), while urinalysis revealed glucosuria 4+ and ketonuria 4+. ABG revealed pH 7.06, PCO2 9 mm Hg, and bicarbonate 2 mmol/L. Anion gap was 28 mmol/L. Tachypnea was a compensatory mechanism for a severe nonlactic metabolic acidosis. The diagnosis of starvation ketoacidosis was established. The patient received supplemental dextrose 10% intravenously and sodium bicarbonate. As fetal heart monitoring was pathological, an emergency caesarean section was performed. Umbilical cord venous pH was 7.01, with PCO2 34 mm Hg and bicarbonate 8 mmol/L. Starvation ketoacidosis is a rare metabolic disorder that may occur mainly in the third trimester of pregnancy. Muscular dystrophy and renal glucosuria were precipitating factors.http://dx.doi.org/10.1155/2013/847942 |
| spellingShingle | Nicolas Cecere Corinne Hubinont Arnauld Kabulu Kadingi Marie-Françoise Vincent Peter Van den Bergh Anna Onnela Philippe Hantson Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section Case Reports in Obstetrics and Gynecology |
| title | Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section |
| title_full | Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section |
| title_fullStr | Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section |
| title_full_unstemmed | Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section |
| title_short | Extreme Maternal Metabolic Acidosis Leading to Fetal Distress and Emergency Caesarean Section |
| title_sort | extreme maternal metabolic acidosis leading to fetal distress and emergency caesarean section |
| url | http://dx.doi.org/10.1155/2013/847942 |
| work_keys_str_mv | AT nicolascecere extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection AT corinnehubinont extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection AT arnauldkabulukadingi extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection AT mariefrancoisevincent extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection AT petervandenbergh extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection AT annaonnela extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection AT philippehantson extremematernalmetabolicacidosisleadingtofetaldistressandemergencycaesareansection |