In plain words
Ketonuria means ketones are found in the urine. Ketones are made when the body breaks down fat for fuel instead of sugar. This can happen when a pregnant person is not eating or cannot keep food down for a while. It is common in , and it often shows up on a urine test at a prenatal visit. Ketones on a test strip are a reason to tell your provider, especially with vomiting, dizziness, or weight loss. Ketones do not, on their own, show how sick someone is. Providers look at hydration, weight, and blood tests as well. Ketones can also appear in people with diabetes, so testing is part of the care plan. Your provider will look at the whole picture.
The deeper version
Urine ketones are detected by nitroprusside-based dipsticks, which react with acetoacetate but not with beta-hydroxybutyrate, the predominant ketone body. Dipstick results can therefore understate ketosis, especially when it is resolving. Pregnancy shortens the time to ketosis because of higher metabolic demand and reduced fasting tolerance. ACOG Practice Bulletin 189 (2018) on notes that ketonuria does not correlate with severity and is not a reliable marker of hyperemesis gravidarum. Clinicians assess hydration, weight change from pre-pregnancy weight, electrolytes, renal function, and liver enzymes when illness is severe. The controversy is how much dipstick ketonuria should guide admission or treatment decisions, when other measures are available.
Where it comes up
- Eating with gestational diabetesPregnancy: Eating
- Eating when nothing sounds goodPregnancy: Eating
- Drinking enough waterPregnancy: Eating
- Nausea and vomiting in pregnancyPregnancy: Your Body
- Hyperemesis gravidarum: when sickness is severePregnancy: Your Body
What mothers here say about ketonuria
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin No. 189: Nausea and Vomiting of Pregnancy, 2018