INTRODUCTION: Starvation ketoacidosis represents a rare but complicated maternal morbidity that primarily occurs in the third trimester of pregnancy. With increased insulin resistance and metabolism m..
INTRODUCTION: Starvation ketoacidosis represents a rare but complicated maternal morbidity that primarily occurs in the third trimester of pregnancy. With increased insulin resistance and metabolism manifesting in pregnancy, prompt care is required to diagnose and treat starvation ketoacidosis as it appears at an accelerated rate. However, despite the severity of maternal and fetal complications arising from this condition, standardized treatment protocols have not been elucidated. CASE PRESENTATION: In this case report, a 33-year-old gravida 3 para 0-2-0-2 at 31 weeks and 5 days gestational age was admitted to antepartum services for intractable nausea, vomiting, and anuria and transferred to the intensive care unit (ICU) on hospital day 3 for starvation ketoacidosis. Prior to ICU transfer, the patient was started on intravenous (IV) Lactated Ringer’s (LR) solution that was transitioned to IV LR with dextrose 5% solution. Laboratory values indicated metabolic acidosis with pH 7.221, partial pressure of CO2 (PaCO2) of 12.9 mmHg, partial pressure of oxygen (PaO2) 91.2 mmHg, and bicarbonate 5.3 mmol/L on arterial blood gas. Serum bicarbonate
