Endocrine Abstracts

Introduction: Starvation ketosis outside pregnancy is a rare phenomenon and is unlikely to cause a severe acidosis. Pregnancy is an insulin resistant state due to placental production of hormones including glucagon and human placental lactogen. Insulin resistance increases with advancing gestation and this confers a susceptibility to ketosis, particularly in the third trimester. Starvation ketoacidosis in pregnancy has been reported and is usually precipitated by a period of s...

Case history: A 40-year-old, primaparous woman was referred at 24 weeks’ gestation to Obstetric Medicine for review of abnormal thyroid function tests (TFTs).Investigations: One year prior to pregnancy, TFTs included a thyroid stimulating hormone (TSH) level of 0.95 mU/l (local non-pregnant reference range 0.3–4.2 mU/l) and a free thyroxine level (fT4) of 7.3 mU/l (local non-pregnant reference range 9.0–23.0 mU/l). At 18 weeks’ gestat...