Introduction
Acute starvation ketoacidosis in pregnancy is a rare affliction with a
severe course of disease for both mother and child. Early recognition
and immediate management are required to minimize the risk of severe
outcome. Ketoacidosis occurs more often in patients with diabetes
mellitus type 1 or alcoholic abuse.1-2 In rare cases,
metabolic acidosis can be a consequence of acute starvation in the third
trimester of pregnancy in non-diabetic patients.3-8Many cases show patients presenting themselves with a short period of
fasting, accompanied by vomiting while patients look clinically
disproportionally well. This kind of presentation also may cause a delay
in recognition and therapy, resulting in a progression of metabolic
acidosis with potentially fatal consequences. We describe a case of
respiratory distress and starvation induced severe metabolic acidosis
during third trimester in a pregnancy complicated by preeclampsia and
gestational diabetes.