Alcoholic ketoacidosis in pregnancy

Area of Science:

• Internal Medicine
• Obstetrics
• Toxicology

Background:

• Alcoholic ketoacidosis is a rare metabolic complication.
• It typically presents with metabolic acidosis, ketosis, and euglycemia (normal blood glucose).
• Pregnancy can alter metabolic homeostasis, potentially increasing risks for certain conditions.

Observation:

• A young pregnant patient, a chronic alcohol abuser, presented with severe ketoacidosis.
• Key clinical signs included arterial pH 7.15, base deficit 23 mEq/L, bicarbonate <10 mEq/L, elevated ketones, and Kussmaul respirations.
• Notably, hyperglycemia and glucosuria were absent.

Findings:

• The patient was successfully treated with intravenous fluids, electrolytes, bicarbonate, glucose, and insulin.
• This case demonstrates successful management of alcoholic ketoacidosis in pregnancy.
• Fetal tolerance to maternal metabolic derangements and labor stress was considered.

Implications:

• This case underscores the importance of considering alcoholic ketoacidosis in pregnant patients with unexplained metabolic acidosis.
• Prompt diagnosis and aggressive management are crucial for maternal and fetal outcomes.
• Understanding the differences and similarities with diabetic ketoacidosis is vital for clinical decision-making.