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Ketonuria

Ketones are formed as a result of metabolism of fatty acids when the body cannot access adequate calories from glucose (derived from carbohydrates) to meet energy requirements and fetal demands, for example, in hyperemesis gravidarum or gestational diabetes. In pregnancy, urinary ketones are tested to assess severity of acidosis and to monitor treatment response. Early detection of ketonuria is essential because ketoacidosis is a factor associated with intrauterine death. Maternal ketonuria in women with post-term pregnancy is associated with a >2-fold increase in the occurrence of oligohydramnios, and a significant increase in fetal heart rate decelerations.

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