Ketosis in pregnant women: causes, consequences, and correction

  • V.I. Medved State Institution “Lukianova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Kyiv, Ukraine


Background. Compared to 2013, in 2019 the number of pregnancies in Ukraine decreased by 32.7 %, so the value of each pregnancy and medical liability have proportionally increased. Because pregnancy is a ketogenic and diabetogenic condition, the issue of ketosis in pregnant women requires close medical attention.

Objective. To describe the causes, consequences and correction of ketosis in pregnant women.

Materials and methods. Analysis of literature sources on this issue.

Results and discussion. Ketosis of pregnant women is divided into diabetic and non-diabetic. The total prevalence of ketosis is 1.7-3.6 %. Risk factors for ketosis in pregnant women include starvation, dehydration, decreased blood buffer capacity, increased production of contrainsular hormones and stress. In addition, ketosis is facilitated by the fact that placenta produces placental lactogen (in late pregnancy – up to 1 g per day) – a powerful contrainsular hormone and ketogenic agent (via stimulating lipolysis in the liver). The development of ketosis is usually provoked by infections, acute diseases, and taking certain medications (glucocorticoids, adrenoblockers). In settings of ketoacidosis, the fetus develops bradycardia, hypoxia and distress, ante- and perinatal mortality increases. If the mother has ketosis with β-oxybutyrate in blood and keto acids in the amniotic fluid, it causes behavioral and intellectual disorders in the child. The links of ketosis pathogenesis include energy starvation due to poor nutrition and/or impaired insulin production, lipase activation with the formation of ketone bodies, protein breakdown, hyperglycemia development, and oxidative stress. The majority of cases of ketosis are diagnosed at the stage of decompensation. Polyatomic alcohol xylitol is one of the main means to eliminate ketosis. Xylitol (Xylate, “Yuria-Pharm”) promotes the formation of glycerophosphate in the pentose phosphate cycle, enhances glycogen production, reduces lipolysis, increases ATP level in liver, promotes insulin production, reduces lactate. The inclusion of Xylate (6-8 ml/kg of body weight for 3 days) into the ketosis therapy can significantly accelerate the elimination of ketosis. Xylate does not increase glucose levels and has nitrogen-sparing properties.

Conclusions. 1. Pregnancy is a ketogenic condition. 2. Ketoacidosis of pregnant women is associated with high perinatal losses. 3. Xylate has shown high antiketogenic activity and a number of additional beneficial effects.

Keywords: ketosis of pregnant women, ketoacidosis, xylitol, Xylate.
How to Cite
Medved, V. (2020). Ketosis in pregnant women: causes, consequences, and correction. Infusion & Chemotherapy, (3.2), 209-210.
Oral presentation materials of IV International Congress of infusion therapy