Ketosis and labour
What happens if I become dehydrated and develop ketosis?
Keep food and fluids up
Ketosis is a complication of dehydration, and a lack of carbohydrates (or glucose) for energy in the body. It is the result of the abnormal accumulation of ketone bodies in the blood stream, body tissues and urine.
Ketosis happens when the muscles have little, or no, glucose for energy to be able to function efficiently. Once the glucose supply in the blood stream is depleted, the body starts to break down its fat stores for energy instead. This produces ketones, often causing a fever, body weakness and the muscles to function inefficiently, including the uterus.
In cases where the ketosis is prolonged, the condition can develop into 'ketoacidosis'. Ketoacidosis makes the person feel unwell and can damage their body organs. This is something that can occur for people who have uncontrolled diabetes.
Ketosis and labour
Ketosis is a common outcome for women who experience a prolonged labour (or prelabour), becoming dehydrated and often causing their contractions to weaken, slow or stop. This can start to happen if glycogen (or glucose) is not being replenished through eating and drinking in their labour.
The work of labour means that the woman's body has high-energy needs, depleting her stores of available glycogen very quickly. When the body has excessive amounts of ketones (meaning the woman is 'ketotic'), she can feel very weak and lethargic, develop a fever and a have fast pulse. Her uterus does not contracting efficiently, and her labour slows (or stops).
Your caregiver can test for ketones with an instant urine stick test, they can also notice if your breath smells 'ketotic', (hard to describe but has a sour, stale odour). Some caregivers may ask for a specimen of urine to test for ketones every few hours, or to confirm what they may suspect.
Image 4-52 shows the urine testing sticks that can be used to detect ketones.