Starvation Ketoacidosis: A Cause of Severe Anion Gap Metabolic Acidosis in Pregnancy

Table 1

Laboratory parameters.

	At admission	12 hours	24 hours	48 hours
pH	7.158	7.199	7.248	7.403
pCO2 (mmHg)	19.0	8.8	20.6	24.1
pO2 (mmHg)	29.4 (venous)	135	246	187
HCO3^− (mg/dL)	5	4	10	16
Anion gap (mmoles/L)	31	29	16	12
Acetone	Moderate	Moderate	Negative	Negative
Lactate (mmoles/L)	1.4	1.0	1.0	1.0
Glucose (mg/dL)	83	80	110	155
Creatinine (mg/dL)	1.4	1.4	1.1	1.2
Potassium (mEq/L)	5.5	3.7	3.1	3.0
Hemoglobin (g/dL)	14.2	12.7	10.1	9.2
Albumin (g/dL)	4.1	—	3.1	3.1
AST (U/L)	37	—	29	34
ALT (U/L)	41	—	34	35
Alkaline phosphatase (U/L)	152	—	116	115
Bilirubin (mg/dL)	0.2	—	0.3	0.3
Serum osmolality (mOsm/Kg)	309	—	—	283
Urine osmolality (mOsm/Kg)	632	—	—	—
Urine analysis	Ketones 2+	—	—	—