Why do ketones in urine increase during pregnancy? Ketone bodies in urine - what does this mean for a woman during pregnancy?

Acetonuria - a phenomenon when urine is excreted from the body acetone . Initially, you need to understand what acetone is.

So, acetone is ketone bodies, which are toxic. Ketone bodies - products of incomplete breakdown of proteins. It is important that this substance must be within acceptable limits. The permissible level in urine is 20-50 mg per day. However, most experts say that the acetone indicator should be zero.

Increased acetone in the urine in children and adults indicates a serious threat to the body. After all, the progression of this condition occurs very quickly, provoking disturbances of consciousness, the development of cerebral edema, disturbances in cardiac activity and breathing. This condition can even lead to death.

Acetonuria is a consequence ketoacidosis (acetonemia ). In this condition, ketone bodies are formed in the blood. If ketone bodies are present in the blood, they are excreted from the body through the kidneys - in the urine. Accordingly, if a laboratory analysis is carried out, this will be reflected in the results obtained. Acetonuria is not a disease or symptom, but a laboratory term. And acetonemia is a term that has clinical significance.

Currently, acetonuria is a fairly common occurrence, whereas in the past it was detected relatively rarely. Currently, acetone in the blood is sometimes detected even in healthy people due to the influence of a number of factors. Acetone also appears in the blood during serious illnesses - severe infections, and others. Below we will discuss the reasons why increased acetone in urine in children and adults, and why does this rate continue to increase?

What are ketone bodies?

If the patient has ketonuria The doctor will explain in detail what this is. But in general, ketonuria is a condition in which a urine test reveals an increased content of ketone bodies. A common occurrence is ketonuria in young children.

Ketone bodies – these are intermediate products that arise when pathological metabolic processes occur in the body. They are formed as waste products of synthesis glucose in the process of breaking down fat.

The main source of energy is glucose, which is formed due to the breakdown carbohydrates . Entering the body with food, they are easily absorbed.

The appearance of ketone bodies in the urine occurs due to a noticeable lack of carbohydrates. Therefore, it is very important that the diet is correct and does not contain a deficiency of substances that ensure the production of glucose.

Since the human body cannot exist without energy, a lack of glucose triggers the process of self-preservation, the essence of which is the breakdown of its own fats and proteins. Pathological processes of self-preservation are usually called gluconeogenesis. As a result of their triggering, toxic ketone bodies are formed. If a small amount of them is produced, then their oxidation in the tissues occurs in the body, and the person exhales them with air or they are excreted from the body in urine.

However, if ketones are released at a rate exceeding the rate of their elimination process, the following pathological reactions can occur in the body:

• damage to brain cells in large quantities;
• there is a very strong dehydration ;
• damage to the gastrointestinal mucosa occurs, which provokes vomiting ;
• there is a violation of the acid-base state, which leads to an underestimation pH blood, that is, the manifestation metabolic ;
• Cardiovascular failure develops, possibly a condition.

Symptoms of acetonuria

Wikipedia and other sources indicate that the first symptoms of acetonuria are the following:

• Initially disappears , which leads to the person refusing to eat and take fluids. Poisoning leads to nausea and prolonged vomiting after eating.
• I am concerned about spasmodic pain in the abdominal area, and the body temperature increases.

It is important for the patient to understand in a timely manner what this means and take the necessary measures. Otherwise, it should be taken into account that this condition worsens over time, and then the patient is bothered by the following symptoms:

• Poisoning And dehydration – the amount of fluid that is released from the body sharply decreases, the skin turns pale and becomes dry, and characteristic redness of the cheeks appears. The tongue becomes dry and coated, the patient suffers from weakness.
• Affected central nervous system . Initially, the patient is excited, but very quickly he becomes lethargic and sleepy. At the same time, it appears constantly. If treatment is not promptly taken, the person may fall into a coma. Possible manifestations of characteristic seizures .
• Appears characteristic smell – the patient’s urine smells not only of acetone, but also vomit and other fluid secreted. The reasons why urine smells like acetone are related specifically to acetonuria. At the same time, the smell of acetone in the urine can be either weak or very pronounced - how intense the smell of acetone in the urine of women, men or children does not indicate the level of severity of the pathology.
• Liver enlarges , which is determined by ultrasound, a number of changes are noted in laboratory tests; transcript of the blood test shows an increase in,. Acetonuria is noted. A biochemical study determines a decrease in chlorides and glucose, an increase in lipoproteins and.

The first signs of this condition can be determined independently. But why women or men exhibit such signs will be explained by a doctor who will confirm the diagnosis.

The pharmaceutical industry offers special test strips that can be used at home to find out whether there is acetone in the urine. These are stripes Ketofan , Ketogluc 1 , Uriket . The price of test strips for acetone in urine is within 200 rubles. for 50 pcs.

To find out the current status, you need to place a new test strip in a container with urine. If a pathology due to which acetone is produced occurs, the tester becomes pink (in the case of a small amount of ketone bodies) or purple-red (if there is severe acetonuria).

Why do ketone bodies appear in urine?

A person should immediately consult a doctor if protein breakdown occurs in large quantities and the acetone norm is significantly exceeded. This is evidenced by the presence of acetone not only in urine, but also in vomit, as well as in saliva.

The most common causes of ketone bodies in urine are:

• Ketone bodies in the urine of a child and an adult appear in the moderate and severe stages. As a rule, this occurs with type 1 or type 2 diabetes, which lasts for a long time. Therefore, if ketones are detected in the urine of a child or an adult, it is necessary to determine the blood sugar level. At the stage of decompensation of diabetes mellitus, a large amount of carbohydrates is lost. In addition, one of the signs of diabetic coma is acetonuria. However, it is impossible to predict the onset of coma based on the degree of its severity, since it can occur with a small amount of acetone or not occur if its amount and the amount of acetoacetic acid in the urine are quite large.
• If a person’s diet is dominated by protein foods and fatty foods. If ketone bodies appear in the urine, what this means can “explain” a person’s dietary habits. With a lack of carbohydrates, the breakdown of fats and proteins becomes difficult. As a result, pathological changes occur.
• Acetone appears due to prolonged and severe diets . Sometimes those who ask doctors: ketones in urine - what does this mean, should reconsider their attitude towards various diets. Indeed, as a result of fasting or strict diets, acidosis manifests itself, that is, an impaired acid-base balance.
• Ketone bodies in urine during pregnancy appear in severe cases. If ketones are detected in the urine during pregnancy, you should immediately tell your doctor about this.
• Enzyme deficiency, which causes disruption of the digestion of carbohydrates.
• Injuries, physical and mental overloads, exacerbations of chronic diseases, the period after surgical interventions - that is, those conditions in which glucose consumption increases.
• Intestinal infections or poisoning, in which acidosis develops due to vomiting and.
• A number of serious diseases - stomach cancer, narrowing of the pylorus, stenosis of the esophagus, cachexia and severe anemia.
• Infectious diseases in which it develops.
• Alcohol poisoning, in which a person suffers from vomiting and diarrhea.
• Mental illnesses.
• Severe hypothermia, excessive physical exertion.
• Oncological diseases, the period of their treatment.

Acetone in the urine of a child

Ketoacidosis not associated with diabetes occurs in most cases in children under 12 years of age. The reasons for acetone in the urine of a child are related to the physiology of the growing organism. We are talking about the following features:

• Children's bodies do not have such large reserves of glucose in the form of glycogen , as in the body of an adult.
• The reasons for acetone in children may be due to the fact that children move a lot and, accordingly, waste energy. Therefore, severe overload and eating disorders affect health more dramatically.
• Since the formation of the pancreas occurs in children under 12 years of age, due to this natural reason, ketone bodies and, accordingly, the smell of acetone may appear in liquids. With a lack of enzymes that are needed to digest food, putrefactive processes begin. As a result, fermentation products enter the blood and kidneys, which is the answer to the question of why the smell of acetone is felt in liquids.

In general, the reasons for the appearance of acetone, like the reasons for sugar in the urine, depend on the same factors in both children and adults. As a rule, an increase in the amount of ketone bodies is associated with a diet that is dominated by fatty foods and junk food. Parents should closely monitor what their baby eats, as poor nutrition directly affects the child’s health.

Every expectant mother should understand that the presence of acetone in the urine indicates pathology and the need for immediate hospitalization. The most common causes of acetone in the urine in pregnant women are manifestations of toxicosis, in which the pregnant woman suffers from severe and regular bouts of vomiting. This leads to dehydration, resulting in the formation of acetone in the urine. Therefore, it is important to act in a timely manner to overcome attacks of nausea with the help of a doctor. If, during toxicosis, the smell of ammonia appears in the urine of women, you should immediately tell your doctor about it.

It is very important to eat right during pregnancy, because eating disorders can also lead to deterioration in health. A woman should not eat a lot of fatty and sweet foods, despite the fact that some expectant mothers are “craved” for such foods.

You shouldn’t go to the other extreme and eat very little for fear of gaining weight. If the expectant mother limits herself to food, this can lead to the development of acetonemia. During pregnancy, split meals are recommended. You need to eat in small portions, while consuming the maximum amount of food that is healthy for the body.

How to treat acetonuria

As mentioned above, acetonuria is a laboratory concept, so we should talk about the treatment of acetonemia. If acetone appears in the urine of adults, the reasons and treatment should be determined by a doctor. After all, the features of treatment directly depend on the diagnosis that was given to the patient. Therefore, it is important to clearly determine the causes of this phenomenon, both in adults and in children.

If acetone appears in the urine during diabetes, treatment involves maintaining normal blood sugar levels. In case of diabetes mellitus, regular monitoring of laboratory parameters and consultation with a doctor is important.

In the event of a temporary disruption of metabolic processes, it is necessary to promptly replenish the body's energy reserves.

If you detect the smell of acetone from a child’s mouth or urine, proceed as follows:

• Provided that the smell appears in a child under 10 years of age, you should initially measure your blood sugar level.
• If we are talking about a healthy baby in whom diabetes mellitus has been ruled out, and the smell of acetone appears for the first time, you need to give the baby sweet tea or give him sweets. In case of vomiting, stress, or infectious diseases in the future, it is necessary to give the baby drinks and food containing sugar.
• If your baby has diabetes, if you smell acetone, you need to measure your sugar level and call an ambulance. After receiving medical help, you need to adjust your diet, lifestyle habits and therapy.

If the smell of acetone appears in an adult or teenager:

• You should undergo screening for diabetes mellitus, and also examine the condition of your liver and kidneys.
• A healthy person who has been following a low-carbohydrate diet for some time should immediately adjust their diet - drink more, eat carbohydrate-containing foods. If you feel unwell, it is better to call a doctor.
• To the patient diabetes mellitus you need to change your sugar level, call an ambulance, and later adjust your diet and treatment.

It is very important to start treatment as early as possible in order to avoid future complications that are dangerous to health and life. Parents who are concerned about how to remove ketone bodies from the body should still consult a doctor. Pregnant women should also talk to a specialist about how to remove acetone from urine. Polyphepan .

After acetonemia has been stopped, it is necessary to take all measures to prevent the re-development of this pathology. If acetonuria develops once, you must act as follows:

• Go through all the examinations prescribed by your doctor, be sure to take general and biochemical blood tests, and a urine test.
• Perform an ultrasound examination of the liver and pancreas.
• Adjust lifestyle and dietary habits, provided that acetonuria occurs regularly.

Those who intend to adjust their lifestyle to prevent such manifestations in the future or to prevent this in a child need to pay attention to maintaining a daily routine, ensuring adequate and timely sleep, and walking in the fresh air for a sufficient amount of time every day.

Also during this period it is worth protecting the child from mental overload, if possible, saving him from additional activities and serious sports competitions. But moderate physical activity is acceptable. Swimming pool exercises are recommended during this period.

It is equally important to adjust your diet - exclude a number of foods and introduce some healthy dishes into your diet.

Which products need to be excluded and which ones should be included in the menu are indicated in the table below.

Of course, after the smell of acetone appears, you should not eat fast food, foods that contain a lot of preservatives, dyes, or drink soda. You should not allow your child to eat mayonnaise, ketchup, mustard and other sauces. You should always remember that nutrition largely determines how quickly the body can recover.

To provide a person and all his organs with energy, the body breaks down glycogen and produces glucose. This is the main energy supplier for the functioning of the brain. Unfortunately, glycogen stores are very limited. When they run out, the body switches to other energy sources - ketones. They are practically absent in the urine and blood of a healthy person. The detection of these substances during analysis indicates an existing pathology.

What are ketones

The name "ketone" comes from the German "acetone". Ketones are substances whose molecules contain an organic compound of oxygen and hydrogen and two hydrocarbon radicals. There are many types of ketones. For example, ubiquinone, it is extremely important for heart function. They contain the ketone group, the well-known fructose, menthone, which is part of oral care products, carvone, used in the food industry, progesterone, cortisone, even tetracycline. Each of us has ketones in our urine and blood, excreting approximately 20-50 mg daily, of which 70% is weak beta-hydroxybutyric acid, 36% is the stronger acetoacetic acid, and 4% is acetone. The last element is the least abundant, because it can be released from the body during breathing. The samples of Lange, Legal and others do not show such a tiny amount. That is why it is believed that in a healthy person the norm of ketones in the urine is their complete absence.

Ketonuria and ketoacidosis

In medicine, there are several conditions associated with ketones. When there are a lot of them in the blood, they talk about ketonemia, and in the urine - about ketonuria. At a sufficiently high content, the pH begins to disturb and ketoacidosis develops. If there are a lot of ketones, but electrolyte changes have not yet begun in the blood, they speak of ketosis. Ketonuria is observed in people with disorders of protein, fat or carbohydrate metabolic processes. This condition often occurs in young children and pregnant women.

There are a number of factors that cause ketone to be detected in urine. The reasons are as follows:

Diabetes;

Traumatic brain injuries;

Hemorrhages;

Operations on the meninges;

Strong stimulation of the nervous system;

Multiple muscle injuries;

Severe infectious diseases;

Glycogen disorders in the body;

Thyrotoxicosis;

Excessive physical activity;

Dysentery;

Frostbite;

Feverish conditions;

Intoxication;

Poor nutrition (multi-day hunger strikes).

In children under 13 years of age, but more commonly under 10 years of age, ketones can be excreted in the urine in large quantities. If this is not associated with the cause, it becomes a violation of the acid-base balance. Symptoms:

Nausea;

Weakness, sometimes to the point of fainting;

Headache (occurs suddenly);

Profuse vomiting;

General weakness;

Sometimes there is pain in the stomach.

During attacks, it is recommended to give Stimol, Citrargenine, and sweet drinks (tea, juice, water with syrup). The nutrition of such children should be strictly dietary, excluding fatty foods, baked goods, especially with chocolate additives, sour fruits and vegetables, and carbonated drinks. When the attack passes, the baby's condition becomes more or less stable. Non-diabetic ketonuria in children can be caused by poor nutrition, fasting, nervous stress in children, and some infectious diseases.

Ketonuria in pregnant women

Ketones in urine during pregnancy can become a harbinger of early toxicosis, as well as a specific disease called occurring only in pregnant women. It occurs when carbohydrate metabolism is disrupted in the body of the expectant mother and is very often detected only during laboratory tests. The woman herself may not feel any pathological changes. However, this disease, which in most cases resolves after childbirth, can be a harbinger of regular diabetes mellitus, as well as endocrine pathologies. If the analysis shows ketones in the urine, the pregnant woman should undergo additional examinations to exclude the presence of true diabetes and thyroid diseases. It is also very important to establish a proper balanced diet, a gentle daily routine, and completely eliminate the use of alcoholic beverages, toxic and harmful substances.

Ketonuria in diabetes mellitus

In insulin-dependent people, ketones are present in the urine daily in amounts of up to 50 g. This condition should be changed towards a significant decrease very quickly, in no more than 2 days. This is achieved by adjusting insulin doses. Urine for research should be taken every 4 hours. The manifestation of ketonuria in children with diabetes mellitus is especially dangerous. For about 10% of them it ends in death. Most often, ketonuria is observed in patients with type I diabetes, that is, insulin dependent. In all other diabetics, an increase in ketones occurs for the following reasons:

Insufficient doses of insulin;

Missed injections or low-quality insulin (expired);

Infectious and colds (sinusitis, pneumonia, meningitis and others);

Thyroid problems and related disorders;

Heart attack, stroke;

Injuries, operations;

Stress;

Taking hormonal contraceptives.

Ketones, diabetes and pregnancy

An indisputable indicator of the presence of diabetes mellitus is the detection along with ketones. If these two substances are detected in the first trimester, there is a high probability that the woman has true diabetes, which existed before pregnancy. This condition is very unfavorable for both the expectant mother and the developing fetus. For a woman, it threatens with polyhydramnios, complicated childbirth, vascular diseases, hypoglycemia, fetal failure, termination of pregnancy, early and late gestosis, and severe toxicosis. A child may be born with various anomalies. Inheritance of the disease is observed in 1.3% of children if the mother is insulin-dependent, and in 6.1% if the father is sick. If ketones are detected in the urine during pregnancy, and the diagnosis of normal diabetes mellitus is confirmed, the expectant mother must undergo the therapy prescribed by the doctor and go on a strict diet.

Diagnostic methods

Determination of ketones in urine can be carried out in the laboratory and at home. The Legal test is publicly available. To perform this, a special strip is soaked in an alkaline substance and placed in the urine for 1 minute. The properties of impregnating solutions are such that if there is an increased proportion of ketones in the urine, they change color from white to brown-red. The brighter the color, the more ketones it contains. This test shows their number only approximately. For more accurate numbers, a blood test is taken. But the Legal test has a huge advantage - you can do it yourself countless times. It is prescribed to diabetics, pregnant women, and children with acetone syndrome. When treating with drugs of the sulfhydryl group (Captopril, Capoten and others), the test is not justified and may give a false result.

Treatment and prevention

Ketosis can be treated at home. The main measure for the patient is a strict diet. Medicines prescribed include Cocarboxylase, Essentiale, Splenin, and Methionine. To prevent ketones in urine from increasing, the following foods should not be consumed:

Soup or borscht with bone, fish, or mushroom broth;

By-products;

Smoked meats;

Pickles, marinades;

River fish (except pike and pike perch);

Fatty foods, including cottage cheese and cheese;

Sour apples, citrus fruits, cherries;

Some vegetables (tomatoes, peppers, eggplants, sorrel, spinach, rhubarb);

Sauces (mayonnaise, ketchup, adjika);

Cream cakes, chocolate, baked goods;

Coffee, carbonated drinks, black tea.

Products to limit:

Canned meat;

Seafood;

Herring;

Legumes;

Pasta;

Cupcakes, biscuits;

Some fruits (bananas, kiwi);

Sour cream.

With progressive ketosis and ketoacidosis, treatment is carried out inpatiently. Prevention of these conditions consists of proper nutrition and a gentle daily routine, and for patients with diabetes - timely insulin injections and regular monitoring of ketones in the urine.

Ketones are specific acetone bodies that are produced in the general metabolic process, during the metabolism of proteins, fats and carbohydrates. They are formed in the liver and excreted by peripheral tissues. Ketones are also partially excreted in urine, but there are so few of them in the urine of a healthy person that they are simply not detected when tested. In this case, ketones are often found in the urine during pregnancy.

Are ketones in urine during pregnancy a warning sign?

This does not necessarily signal a specific pathology, but may be associated with the presence of gestational diabetes mellitus, preeclampsia, thyrotoxicosis, extensive infectious processes and other disorders. Therefore, if the analysis shows an increased concentration of ketones, the woman is traditionally prescribed a thorough medical examination.

Such test results should under no circumstances cause you to panic. Please note that they do not always indicate diabetes or other serious disorders.

Ketones have been clinically proven to be the most important source of energy in our body. They nourish almost all tissues, with the exception of the liver, maintaining energy balance within the body. The liver tissue receptors are the least sensitive and therefore cannot adequately respond to and use the body.

During the period of therapeutic fasting, it is ketones that provide active nutrition for the brain. Therefore, they are often produced in the body of a healthy woman during diets and long fasting days. They are also often found in those who practice intense physical activity.

However, in this case, their amount in the urine usually increases slightly. So, what could be causing increased ketones in urine during pregnancy?

Traces of ketones in the urine of a pregnant woman do not always signal disorders occurring in her body. This factor can be purely physiological, and is sometimes regarded as the norm.

It's no secret that the body of the expectant mother bears enormous loads. If he does not have time to adapt to the changes occurring in the functioning of vital organs and systems, ketones may be observed in the urine.

Why is this happening? The fact is that the liver and kidneys are responsible for the disposal of metabolic products. Ketones, which are a breakdown product during the breakdown of proteins, do not have time to be excreted by these organs due to the additional load created by the fetus.

Therefore, if traces of ketones in the urine appear during pregnancy in its first trimester, this only indicates that the body cannot yet cope with the changes occurring in its components.

However, if this phenomenon persists into the second trimester, it makes sense to assume the presence of gestosis - this is the term used for late toxicosis, which, if ignored by the patient or doctor, can seriously harm both the maternal body and the intrauterine life of the fetus.

Know that increased acetone in the urine during gestosis can lead to the most tragic consequences. And if your doctor ignores this phenomenon, it makes sense to contact another specialist in the field of obstetrics and gynecology.

What is the norm and what is considered a deviation?

Acetone bodies can be detected in a woman’s urine at about 17 weeks of gestation. There are no norms for ketones in urine during pregnancy - ideally, there should be none at all (in other words, they are present in the body of any healthy person in low concentrations and are not detected during the study of biological fluid).

However, if they increase slightly, it is too early to talk about the development of pathology, especially at the indicated period.

It’s a completely different matter when the amount of acetone bodies in the urine increases sharply. Usually this condition does not go away without leaving a trace for the woman herself - she feels bad, lethargic and tired. In addition, this phenomenon is almost always accompanied by nausea and vomiting.

Causes of Increased Ketones

Ketones may appear in the urine of an expectant mother due to malnutrition. Therefore, if your diet is dominated by protein and fatty foods, and there is also a persistent deficiency of complex carbohydrates, you should not be surprised by the results of the analysis.

Acetone bodies may also predominate in urine due to dehydration due to prolonged vomiting. This is especially true for those women who suffer from severe manifestations of toxicosis.

Other reasons for increasing the concentration of ketones in urine:

• Long-term consumption of foods enriched with ketogenic substances;
• Following a low-carbohydrate diet (or a minimum amount of carbohydrate-containing foods in the usual diet);
• Alcohol intoxication;
• The presence of slightly alkaline food products in a woman’s usual menu;
• Chemical poisoning (such as lead or mercury);
• Fever;
• Diabetes;
• Some infectious pathologies (tuberculosis, influenza, scarlet fever, etc.);
• Excessive psycho-emotional stress, nervous tension, increased excitability.

Among the more dangerous, but less common causes of ketonuria during pregnancy, the following factors should be highlighted:

• Oncological processes;
• Severe liver pathologies;
• Serious hormonal disorders that can lead to miscarriage or miscarriage at any stage.

What to do?

Almost all of these conditions do not require specific drug treatment. In case of infectious invasions, ketones in the urine have no diagnostic significance: in this case, doctors treat only the root cause of their appearance. With fever, the cause of the disorder is also decisive.

In case of poisoning with alcohol, chemicals or drugs, a woman requires urgent hospitalization, coupled with rapid cleansing of the body and special therapy to help neutralize the effects of toxins on the body.

For diabetic patients, a special diet is prescribed. Usually, it is enough for a woman to monitor the levels of glucose in her blood and promptly compensate for the course of the disease. For gestational diabetes, specific treatment may be prescribed.

In any case, if ketonuria (increased acetone bodies in the urine) is caused by non-physiological processes, the doctor should examine you in detail and, if necessary, arrange for urgent hospitalization.

How are pregnant patients with ketonuria examined?

If an increase in acetone bodies in the urine of a pregnant woman raises any alarming suspicions among the doctor, he will refer the patient for a number of additional studies.

Their standard package includes:

• General clinical blood test;
• Biochemical blood analysis with an in-depth study of the concentration of acetone bodies in it;
• Blood test for glucose concentration;
• Glucose tolerance test;
• Ultrasound examination of the thyroid gland and abdominal organs.

A pregnant woman must consult an endocrinologist to find out the specific causes of ketonuria in her case. Also, if necessary, the endocrinologist prescribes appropriate treatment, depending on the pathology and the period at which it was discovered.

Most often, acetone in the urine signals long-term toxicosis, which is traditionally accompanied by intense vomiting and dehydration. In the absence of adequate measures to treat gestosis, it can provoke irreversible and tragic consequences for both the woman herself and her unborn child.

Preeclampsia can result in the following complications:

• Premature birth;
• Fetal intoxication;
• Severe form of maternal dehydration;
• Coma;
• Miscarriage (spontaneous termination of pregnancy at any current stage);
• Fading pregnancy or stillbirth;
• Death.

Ketones in the urine of a pregnant woman appear as a result of increased load on the liver. During the metabolic process, when fats are dissolved, ketone bodies are formed, which are practically not detected in urine or are diagnosed in minimal quantities. Exceeding normal levels is dangerous for the formation of the fetus and can lead to intoxication of the entire body.

Norm of ketone bodies in urine during pregnancy - table

If a pregnant woman follows the rules of a healthy balanced diet, where all vitamins and minerals are present in abundance, then the body will not turn to fatty tissues; energy is generated from incoming carbohydrates. With a lack of nutrition or due to the use of a long diet, ketonuria develops, and the urine acquires a sharp acetone odor.

The norm of ketones in the daily volume of urine is no more than 25 mg; for a pregnant woman, this parameter expands slightly to 50 mg, due to the high workload of the liver. If the analysis constantly shows that ketone bodies in the urine are elevated, then corresponding symptoms always appear: nausea, vomiting, lethargy, general fatigue and tiredness.

Glucose and ketones in urine during pregnancy are inextricably linked, so there are special test strips to monitor these indicators (the strip is lowered into a container with urine for 4-5 seconds). When deciphering a study using an indicator at home, the presence of ketone bodies is indicated by the appropriate color scheme and plus signs:

The table shows general information, but in the laboratory the exact acetone content can be determined, since a significant increase may indicate the formation of gestational diabetes mellitus, which will require immediate treatment.

Reasons for the increase in ketone bodies during pregnancy

In most cases, increased acetone in urine indicates poor nutrition, when proteins and fats predominate in the daily menu against a background of carbohydrate deficiency. In such a situation, it will be enough to adjust the diet, the main parameters of which will be indicated by the doctor, and when the tests are repeated, the level will become significantly lower.

Other reasons that cause the predominance of acetone include:

• alcohol poisoning;
• regular consumption of slightly alkaline foods;
• intoxication with chemicals (lead, mercury);
• diabetes;
• infectious diseases accompanied by fever.

How to reduce ketones in urine

A diet for ketones in the urine in pregnant women is prescribed if diabetes mellitus or gestational diabetes is diagnosed. You will need not only a balanced diet and food rich in vitamins, but also a split diet and the exclusion of fried and fatty foods. Daily walks in the fresh air and, equally important, proper sleep are recommended in order to normalize glucose.

During toxicosis and dehydration, infusion therapy is prescribed. In the absence of diabetes, the analysis is improved by intravenous administration of glucose and ascorbic acid.

With a one-time increase in acetone, a pregnant woman is at risk; constant monitoring of the dynamics of an increase or decrease in sugar is necessary in order to timely adjust treatment measures and prevent threatening consequences for the life of the mother and child.

During the entire period of pregnancy, the expectant mother undergoes a whole bunch of tests so that doctors can keep the condition of the woman and her baby under control. One of these tests is to determine the concentration of ketone bodies in the urine. Overall, it shows how the body copes with increasing load. A deviation in the concentration of ketone bodies from the norm may indicate possible pregnancy abnormalities. In today's article we will describe in detail what ketone bodies are and what their content in urine is.

Ketone bodies are a metabolic product. They are released from the liver during the breakdown of fats and the release of energy. During normal functioning of the body, ketone bodies continue to participate in the metabolic process, are broken down and excreted from the body as small trace elements.

It is worth noting that ketone bodies outside medical circles are usually called acetone (betahydrobutyric and acetoacetic acids). During pregnancy, the rate of formation of ketone bodies increases significantly, and the load on the liver also increases, because the organ simply does not have time to process them. When acetone is detected in the urine of an expectant mother, doctors sound the alarm, because this substance, especially at high concentrations, is dangerous for both the pregnant woman and the fetus. The main harm to the body is that ketones poison the body, contributing to the development of intoxication. Experts call an increase in ketone bodies in the urine of a pregnant woman ketonuria and may even prescribe inpatient treatment in order to monitor the condition of the mother and fetus.

Ketone bodies during pregnancy: normal

During normal functioning of the body, ketone bodies should not be detected in the urine during pregnancy. In general, approximately 20-50 milligrams of ketone bodies are released per day. This volume must be fully processed and broken down along with other decomposition products.

However, it is worth noting that traces of ketone bodies in urine during pregnancy do not always indicate abnormalities. For example, as a rule, acetone bodies are often found at 17 weeks of pregnancy. A slight increase in ketones in urine during pregnancy may indicate that the body simply does not have time to adapt to a sharp increase in loads.

The reason for concern should be a sharp jump in acetone bodies in the urine, while the woman herself will feel an increase in ketones. For example, if ketone bodies increase to 6 mmol l during pregnancy, then the expectant mother will most likely feel weak, tired, headache or dizzy. Symptoms may also include nausea and vomiting. A sharp and significant increase in ketone bodies in the urine during pregnancy may indicate:

• about the presence of decompensated diabetes mellitus;
• about infectious processes in the body;
• about an increase in corticosteroids;
• about poor nutrition (eating large amounts of fats and carbohydrates and small amounts of proteins) or fasting;
• about thyrotoxicosis;
• about Gierke's disease or coma;
• about hormonal imbalances;
• about fever;
• about poisoning;
• about cancer.

Ketone bodies in urine during pregnancy: how to detect

To detect ketone bodies in urine during pregnancy, it is enough to submit urine for a general urine test. If the concentration of ketones is increased (more than 1.5 mmol l), you may also be prescribed the following tests:

• general blood analysis;
• blood test for the concentration of ketone bodies;
• blood chemistry;
• glucose tolerance test;
• Ultrasound of the thyroid gland, liver and other internal organs.

In addition, in case of ketonuria in pregnant women, a consultation with an endocrinologist is required to clarify the specific causes of acetone and prescribe adequate treatment.

How to determine the level of ketone bodies at home

Traces of ketone bodies in urine during pregnancy can be detected independently at home. To do this, you need to purchase a special test strip or test tablet from the pharmacy to detect ketones.

How to diagnose ketone bodies using a test strip.

1. Wash with a mild intimate hygiene product.
2. Collect your morning urine sample in a sterile container.
3. Remove the test strip from the package.
4. Immerse the test strip in urine to the indicated level.
5. After 2-3 seconds, take out the test strip.
6. After 20 seconds, evaluate the result: if the color of the test is deep yellow, then there are no ketone bodies in the urine. If the color is darker, even dark purple, then ketones are present in the urine in different concentrations, depending on the color of the strip.

How to test urine ketone levels using a test tablet.

1. Collect your morning urine sample.
2. Remove the test tablet from the package.
3. Place the test tablet on a clean white sheet of paper.
4. Drop 1-2 drops of urine into the indicated area on the test tablet.
5. After 30 minutes, evaluate the result of the test tablet by comparing its color with the standard scale included in the kit.

What to do if ketone bodies in urine are increased during pregnancy

If there is an increase in ketone bodies in the urine, you should urgently consult a doctor. If there is a significant and sudden increase in ketones, you may be recommended to undergo inpatient treatment, which includes drug intervention. In particular, a drip is often prescribed through which vitamin complexes and glucose are supplied. This treatment is especially necessary if the woman herself feels unwell:

• feels unwell;
• there is weight loss;
• there is a feeling of constant fatigue;
• the patient has a headache or dizziness;
• the woman constantly feels sick and vomits.

For ketonuria, I also always prescribe a diet, the adherence to which directly determines the success of treatment. If ketone bodies increase during pregnancy:

• Meat can only be consumed boiled or baked. It is allowed to eat rabbit, beef and turkey;
• light vegetable soups and low-fat fish are allowed;
• you can eat porridge;
• Quince is recommended for consumption;
• Sweets, spices, canned food, pickles, smoked meats, fatty meats, broths, fried foods, bananas, and citrus fruits are prohibited.

Also, if there is an increase in ketone bodies in the urine, it is recommended to drink juices, fruit drinks and compotes. Systematic fluid intake and restoration of electrolyte balance speeds up the healing process.

Increased ketone bodies in urine during pregnancy: what are the dangers?

A high concentration of ketone bodies in the body is very dangerous for a pregnant woman and her fetus. In the absence of adequate treatment, the following problems may arise when ketone bodies in the urine increase during pregnancy:

• intoxication of the expectant mother;
• fetal intoxication;
• miscarriage;
• severe dehydration;
• coma;
• fatal outcome.

Ketone bodies in urine during pregnancy. Video