Ketones in the Urine During Pregnancy – Causes,Treatment, and Prevention
Medically Reviewed By
Dr. Archana Dhawan Bajaj
(Gynecologist/Obstetrician)
Pregnancy brings a whole new outlook on life. There is excitement, no doubt, but there are pregnancy symptoms and health concerns, too. Some pregnancy symptoms are quite common and can be dealt with easily with simple remedies, while others might need medical attention. Similarly, pregnancy-related health conditions are better diagnosed early on for proper treatment. One condition distressing for pregnant women is having ketones in the urine. This article will discuss what ketones are, their causes, treatment, and prevention. What are we waiting for, then? Let’s begin with what ketones in the urine during pregnancy are:
What Are Ketones?
Our body gets energy and glucose from the food that we consume. The changing pregnancy hormones can prevent the cells from using up glucose, leading to a glucose deficiency. In case of a deficiency of this element, the body uses the fat reserves to attain the required energy. This condition leads to the production of ketones. Ketone bodies are organic compounds, composed of acetoacetate, acetone, and beta-hydroxybutyrate, produced from the breakdown of fatty acids in the liver (1).
Is It Normal to Have Ketones in Urine While Pregnant?
The presence of ketones in urine during pregnancy is considered normal, observed in at least one in five women (2). However, that depends on the amount of ketones in the body, which may or may not indicate a potential health concern. Ketones are produced when the body breaks down fat for energy instead of using glucose (sugar). This can occur when the body is not getting enough carbohydrates or when there is a problem with insulin function. The body needs a consistent energy source during pregnancy to support the mother and the developing fetus. Suppose the body is using fat as the primary source of energy. In that case, it may indicate an inadequate carbohydrate intake or a problem with insulin regulation, such as gestational diabetes.
Elevated ketone levels can happen due to exercising for too long, an improper diet, or following a ketogenic diet (3). A 2017 study published in Obstetric Medicine found that approximately 22% experienced some degree of ketonuria during pregnancy (2). Therefore, if you occasionally detect ketones during pregnancy, it may not necessarily be associated with problems like gestational diabetes
What Causes Ketones in the Urine During Pregnancy?
Some of the causes that contribute to the presence of ketones in the urine are (4):
- Dehydration
- Unmanaged diabetes
- A diet lacking in nutrition or a low-carb diet
- Excessive or frequent vomiting or diarrhoea caused by morning sickness
- Excessive exercising
- Skipping snacks or meals during pregnancy
- Not eating meals on time or taking long gaps between meals
- Pregnancy symptoms include severe vomiting
- Metabolic disorders or underlying infections/illness
- Fasting while pregnant
- Development of insulin resistance during pregnancy
Once the cause is known, testing can be done to determine the levels of ketones to make the diagnosis.
Diagnosis and Tests for Ketones in Urine While Pregnant
How do experts trace ketones in urine pregnancy? A gynaecologist will test the levels of ketones in the urine through a urine and/or blood test. If the ketone levels are high, additional tests will be suggested to rule out gestational diabetes. A specific number or words, such as “small,” “moderate,” or “large,” could appear next to your test results if ketones were detected. Your diet, activity level, and other things may affect your normal readings. Serious health issues can result from high ketone levels.
Now, you are probably wondering who should take the ketone test. Read on to know more about ketones in urine treatment during pregnancy.
Who Should Take a Ketone Test?
Most of the time, gynaecologists would suggest that women take a ketone test if they show any of the symptoms given above. Still, women with Type 1 diabetes are more susceptible to developing ketones than those with Type 2 diabetes. Therefore, you should take the test if you’re pregnant and face the following symptoms of ketones in urine during pregnancy:
- Your blood sugar levels remain steady at 250 mg/dl for two days in a row
- You’re sick or injured
- You want to start exercising
How to Test for Ketones at Home?
Yes, it’s possible to check the ketone levels at home, too! For this, you need to buy a testing strip from a pharmacy. When you wake up, collect your urine in a clean container and dip the strip into it. Take the strip out and leave it undisturbed for a few minutes. Compare the strip’s colour to the colour guide on the testing kit. The result ranges from negative to large. Mild ketosis is also assessed using urine dipsticks. However, the accuracy of this test has not been tested.
Can Ketones in Urine During Pregnancy Cause Any Symptoms?
A small amount of ketones in urine is usually fine. You won’t have any related symptoms, but high levels of ketones in the body can be harmful. Symptoms may include (4):
- Excessive thirst even after drinking plenty of water
- Headache
- Feeling excess tiredness
Can the Presence of Ketones in the Urine Harm Your Baby?
If present in small amounts, ketones don’t pose a risk to the pregnancy. But high levels of ketones can lead to pregnancy complications like ketonuria. Higher levels of ketones in the urine may also indicate diabetic ketoacidosis (DKA) (5). Some studies indicate that babies born to mothers with high ketone levels may develop learning disabilities. The placenta allows ketone bodies to move around easily. In particular, they can harm the developing central nervous system and have an impact on foetal growth (6).
Prevention of Ketone in Urine During Pregnancy
You can prevent the production of ketones during pregnancy by eating a balanced and nutritious diet throughout. Here are some precautions to take to reduce pregnancy ketones in urine:
- Avoid fasting and have meals on time.
- Eat three snacks and three meals on time.
- Have a snack before bedtime.
- Refrain from taking long gaps between meals. Instead, satiate your hunger with healthy snacks.
- While you’re pregnant, it’s important to keep yourself hydrated by drinking plenty of water.
- Taking adequate rest is also important during pregnancy.
- Include moderate exercise in your daily routine.
- Maintaining a food journal or diary can help you keep track of your calorie intake.
If you have any concerns about your diet, consult a nutritionist for proper guidance.
When to Consult a Doctor?
While the presence of ketones in urine during pregnancy generally warrants consulting a doctor or healthcare provider, here are five specific situations when it becomes absolutely necessary to seek medical attention:
- High levels of ketones: If the ketone levels in your urine are significantly high, it is crucial to consult a doctor. High ketone levels may indicate a more severe metabolic imbalance and require immediate attention.
- Persistent or worsening symptoms: If you experience persistent symptoms associated with ketonuria, such as frequent urination, excessive thirst, fatigue, nausea, or abdominal pain, it is important to consult a doctor. These symptoms could be signs of an underlying health issue that needs medical evaluation and management.
- Gestational diabetes: If you have a history of gestational diabetes or are at risk of developing it and notice ketones in your urine, it is essential to consult your healthcare provider. Gestational diabetes requires careful monitoring and management to prevent complications for both the mother and the baby.
- Lack of improvement with dietary changes: If you have adjusted your diet and lifestyle to increase carbohydrate intake and reduce ketone production but notice little to no improvement in the presence of ketones in your urine, it is advisable to consult a doctor. They can assess the situation, explore other potential causes, and provide appropriate guidance or interventions.
- Hyperthyroidism: Hyperthyroidism can also lead to elevated ketones in urine during pregnancy. It can affect metabolism and potentially impact blood sugar control, which could contribute to the development of gestational diabetes – a direct cause of high ketone levels.
FAQs
1. What is the normal range of ketones in urine during pregnancy?
The normal ketone level in urine during pregnancy is typically considered negative or trace amounts. Ideally, there should be no detectable ketones in the urine. However, it is important to note that the specific reference ranges may vary slightly depending on the laboratory or healthcare provider. Consulting your healthcare provider can provide the most accurate information regarding the normal range of ketones in urine during pregnancy.
2. Why do I have ketones in urine even if I don’t have diabetes?
While ketones in urine are often associated with diabetes, it is possible to have ketones in urine even if you don’t have diabetes. Several factors can contribute to the presence of ketones:
- Low carbohydrate intake: If your diet is low in carbohydrates, your body may not have enough glucose for energy, leading to the breakdown of fat and the production of ketones.
- Fasting or prolonged periods without food: When you go without food for an extended period, such as during fasting or if you have a poor appetite, your body may rely on fat metabolism, resulting in the production of ketones.
- Intense physical activity: Intense exercise or physical activity can deplete glycogen (stored glucose) levels. In such cases, the body may produce ketones to compensate for the energy demand.
- Certain medical conditions: Other medical conditions, such as hyperemesis gravidarum (severe nausea and vomiting during pregnancy), can lead to inadequate food intake, resulting in ketone production.
3. What does a high amount of ketones in urine indicate while pregnant?
The specific range indicating high ketones in urine during pregnancy may vary depending on the laboratory or healthcare provider. Generally, a high amount of ketones in the urine is indicated when the levels exceed trace amounts. Your healthcare provider can provide the appropriate reference range and interpretation based on your circumstances.
Pregnancy and ketones in urine have an inverse proportional relationship. Thus, caution is necessary. Since every individual’s situation is unique, it is essential to consult a healthcare professional for personalised advice and guidance when dealing with ketonuria during pregnancy. Traces of ketones in the urine during pregnancy isn’t a serious issue. However, higher levels of ketones require proper diagnosis and suitable treatment to prevent any likely complications.
Also Read:
Leukocytes in Urine while Pregnant
Change in Urine Colour in Pregnancy
Urine Colour during Pregnancy
Urine Test and Urine Culture when Pregnant
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