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Ketones in the urine during pregnancy is a health concern which some women experience during those crucial nine months. Although, it is not a high-risk pregnancy complication, studies reveal that it can be a cause of worry.

Ketones are substances derived from fat breakdown. They are used by the body as a source of energy under emergency circumstances, like starvation or glucose deficiency, in order to survive. In other words, ketones in the urine are formed when the body's fat reserves are used to generate energy.

Ketones in the blood further leads to ketosis. Weakness, nausea, lethargy, and excess sweating are signs of ketosis.

Occurrence

Our body gets its energy from the food we eat, which gets converted into glucose or blood sugar. It is insulin which provides an easy access to this blood sugar. During pregnancy, the placental hormones make the body resistant to insulin, which subsequently restricts the glucose in the blood from entering the cells. Hence, though the blood will be enriched with blood sugar, the cells will be deprived of the required energy. As a result, the cells start accessing other energy sources, like the fat stores, resulting in ketones as the byproduct of this entire process.
Causes

There can be various factors that may contribute to large ketones in the urine during pregnancy; dehydration and bad diet, to name a few. Others are enlisted below:

Not getting enough calories from the food you are eating
Long time intervals between meals
Skipping meals or snacks
Gestational diabetes
Diets which include low intake of carbohydrates
Dehydration - not drinking enough water
Metabolic disorders
Nausea, poor eating habits or throwing up
Insulin resistance from hormones as a result of which the body is unable to access blood sugar
Testing

Ketone testing is very much different from normal urine sugar tests. You need to wash yourself properly, and collect your urine in a sample box. It is better to let a small amount of the initial urine fall into the commode. This will clear the urethra of contaminants. About 1 or 2 oz. of urine will be sufficient for the test. Then you can ask your health care provider to examine the presence of ketones in your urine. Nowadays, different ketone sticks are available in the market which can be used for ketone testing.

For optimum results, it is better to use the first sample of urine (taken first in the morning) for testing, as due to the overnight fast, the blood sugar levels drop. It is then that the body starts looking for fat stores as a source of energy, which results in giving off or spilling of ketones in urine.

You may have to go on a different diet before you take the test. Please make sure not to consume any drugs before the test. Doing so might affect the test results. The test does not cause any discomfort, as it is carried out through normal urination samples itself. There are no risks either. It is always important to take a ketone test during pregnancy, as high levels of ketones in the urine can be harmful to you and your baby.

If ketones are present in your urine, the test results are said to be abnormal. The abnormality is categorized into three parts. Small is < 20mg/dL, moderate would be 30 - 40 mg/dL and large would be > 80 mg/dL. Small amount may mean that the build-up has just started. Conduct the test again after few hours. Moderate or large amounts may prove to be dangerous. Ask for a doctor's opinion in the latter case.
Prevention

It is always recommended to consult a doctor for this problem. In order to prevent ketones in general, you should avoid skipping meals or having long gaps between each meal. You should eat after every 3 to 4 hours during pregnancy. Also, try having a good bedtime snack which should be rich in proteins and starch. This is because protein slows down the absorption of carbohydrates, which benefits by making energy available to the body for a longer duration of time.

Also, remember not to keep more than 9 to 10 hours gap between your bedtime snack and breakfast, as this will lower the risk of presence of ketones in urine. Hence, consider having small yet frequent meals, high in proteins and starch, in order to avoid the situation.

However, there have been cases when the patient isn't starving, nor is she dehydrated, but still spills ketones in her urine. In such cases, putting on weight by overeating is not the solution. It is necessary to eat nutritious food like fruits and vegetables. Drinking plenty of water will keep your baby healthy.

During pregnancy, one should consume about 1800 to 2500 calories, on a daily basis. Maintaining a food diary or journal should prove helpful to keep a count on what you have been eating, along with the time and calorie count. Seek advice from a nutritionist or refer to pregnancy diets for proper guidance. You could also attend weight watcher meetings.
To conclude, we can say that occasional traces of ketone bodies in urine during pregnancy do not seem to be a very serious problem; unless there are larger amounts or frequent bouts of ketones in urine. Whether traces of ketones in urine during pregnancy is dangerous or not, is a debatable topic. However, some studies emphasize that women with large amounts of ketones, may have babies with learning disabilities or reduced IQ later in life.

Regular monitoring of the first urine in the morning (for ketones by a midwife or doctor), especially in women having gestational diabetes, can help in preventing as well as treating this health ailment.

Disclaimer: This Buzzle article is for informative purposes only, and should not be used as a replacement for expert medical advice.