Are Ketones in your urine during pregnancy a huge issue?

Beccaboo0713

I was in triage last night for 6.5 hours for fever and dehydration. The baby was showing up as lethargic, the did a chest xray to rule out pneumonia, a flu test, and took tons of urine samples. It turns out I have the flu so they put me on the z pack (for underlying infection) and gave me tamiflu.

The reason I was there so long is because they kept checking my urine and it kept showing moderate amounts of ketones. I had an IV and drank 1000cc's in liquid (juice and water). Finally they told me I could be discharged if I checked my keytones this morning at home and called them if they are still not 'normal'. Otherwise they wanted to admit me.  Well I check this morning and they aren't normal.

I looked it up and from what I found it's not from dehydration but from starvation. 

I was just wondering if ketones in urine are really that bad. The reason I am asking here and not just calling my doctor is because I think the doctor on call is an idiot. (this is not my first encounter with him)

chicsub

I had the norovirus twice this pregnancy (joy) and after the first bout I had a prenatal appointment and had ketones.  I researched the crap out of it as usual b/c that's what I do!    Ketones can stay in your urine for several days (vs. checking your blood) after you are back to normal, hydrated and no longer starving.  It's a bigger deal when you have GD, but that's also up for debate. 

AllyInMaine

I'm not an expert... but I believe ketones mean your body is in starvation mode, which for a growing baby, is a problem. Try to eat something (I know you have the flu). What did your doctor tell you? Are you eating enough?

Beccaboo0713

I am not eating enough. I told him that but he kept pushing the fluids (and juice). I also IR so that could be a problem too. He was just so hung up on the fluids. I kept telling him I hadn't ate anything in 10 hours and even then it was just a bowl of ramen.

iris427

I had them in my urine at my first prenatal appointment--because of morning sickness I was barely eating.  My doctor told me to make sure I was getting more to eat but he didn't seem super concerned.  I don't know if it would be more of a problem in the third trimester.  What did they tell you to do?

Beccaboo0713

They told me to drink Gatorade and eat something and check my urine again this morning. I did and it's still moderate. The doctor seemed really concerned about it but the nurse thought he was just being difficult. I am going to try to drink more Gatorade and eat something and see what happens. I really don't want to call him. We are snowed in.

kiley&matt

I have to check my ketones every day because I have GD, and it basically means that you're not getting enough carbohydrates and your body is using stored fat for energy, and basically going into "starvation mode".  It's definitely not good for your baby and can cause learning disabilities and a lowered IQ, so try to eat a little more if you're feeling better.  Also, eat smaller meals more often, as this will spread out the "energy" you're consuming so that your body isn't going into starvation mode.  Drinking a lot of water can also help flush the ketones out of your system, but this won't help as much if you're still not getting enough to eat.  Good luck!

BrendaK

I've had GD though both of my entire pregnancies (probably Type 2 undiagnosed, but since they found it during my pregnancies and have never tested me otherwise, they call it GD). 

PP's are right - it's a sign that your body is not getting enough food, and is burning your reserves (fat/sugar). 

I dealt with ketones through my entire first pregnancy. When they first started me on the GD-diet (8-9 weeks), I was spilling moderate-large amounts. My doctors kept increasing my food to the point where I was eating SO much more than I was before I was even pregnant, and had to go on insulin as a result. About half-way through my pregnancy (increasing my food/insulin the entire time), they started to go down to a trace-small amount. My doctors would have preferred that they were negative all the time, but it just wasn't happening. I lost weight my entire pregnancy, up until the last few weeks.

I kept the weight off from my first pregnancy, and ketones have been much less of an issue this time around. I get occasional traces, but definitely not the struggle I had last time. I've been able to eat "normal" and not have to take as much insulin.

Here is a great site about ketones: https://www.plus-size-pregnancy.org/gd/gd_ketones.htm

Like PP mentioned, there are old studies that "linked" ketones to lower IQ's, but there are also studies that show those studies are incorrect (the link above discusses it). My OB, my MFM, my diabetes specialist, and my Endo all told me that those studies are inconclusive and outdated, and to not worry about ketones having a major effect on my baby - baby will take what s/he needs from you.

FWIW, with spilling ketones for the majority of my first pregnancy, my daughter came out absolutely perfect. She's clearly, at least to me and her pedi, learning at a great rate and developing perfectly. 

So, I wouldn't stress too much, but I would work on eating as much as you can! 

Beccaboo0713

Thank you for all the wonderful information. After eating a couple slices of pizza and drinking almost 32 oz of Gatorade my ketones dropped to trace. I haven't been eating but 1/4 of what I normally eat for the last 3 days so that is probably my biggest issue.

kabarbanel

When I had ketones on my urine, my Dr told me it was most likely from dehydration.

Beccaboo0713

I am not dehydrated. There is no way I could be.

I took a ketone test at 11:15 (right after lunch) and it was in between trace and none. I took one again after dinner at 5:30 and it was back up in between moderate and large.