Severe metabolic alkalosis in pregnancy

Abstract

Metabolic alkalosis is uncommon in pregnancy and is most often the result of severe vomiting. If this is present at the time of delivery, transient metabolic derangement in the fetus can occur, potentially requiring additional organ support. A 22-year-old woman is described, who presented at 37 weeks gestation with a severe metabolic alkalosis, vomiting and acute renal and hepatic impairment. The investigations, management options and maternal and fetal outcome are described.

The Role of Placental Hormones in Mediating Maternal Adaptations to Support Pregnancy and Lactation

“…Many of the changes described in the figure for women during pregnancy also occur in other species, including mice. Respiratory system (Macrae and Palavradji, 1967 ; Weinberger et al, 1980 ; Contreras et al, 1991 ; Hegewald and Crapo, 2011 ; Frise et al, 2013 ; Lomauro and Aliverti, 2015 ; Soma-Pillay et al, 2016 ); cardiovascular system (Adamova et al, 2009 ; Li et al, 2012 ; Pieper, 2015 ; Soma-Pillay et al, 2016 ); hematological system (Shakhmatova et al, 2000 ; Chang and Streitman, 2012 ; Rodger et al, 2015 ; Soma-Pillay et al, 2016 ); spleen (Maroni and De Sousa, 1973 ; Sasaki et al, 1981 ; Norton et al, 2009 ); renal system (Davison and Dunlop, 1980 ; Atherton et al, 1982 ; Krutzén et al, 1992 ; Elsheikh et al, 2001 ; Cheung and Lafayette, 2013 ; Lumbers and Pringle, 2014 ; Pieper, 2015 ; Soma-Pillay et al, 2016 ); pancreas (Ziegler et al, 1985 ; Ernst et al, 2011 ; Ohara-Imaizumi et al, 2013 ; Baeyens et al, 2016 ); adipose tissue (Catalano et al, 2006 ; Hauguel-De Mouzon et al, 2006 ; Lain and Catalano, 2007 ; Nien et al, 2007 ; Hadden and Mclaughlin, 2009 ; Valsamakis et al, 2010 ; Musial et al, 2016 ); skeletal muscle (Alperin et al, 2015 , 2016 ; Musial et al, 2016 ); bone (Shahtaheri et al, 1999 ; Ulrich et al, 2003 ; Hellmeyer et al, 2006 ; Salles, 2016 ); digestive tract (Everson, 1992 ; Fudge and Kovacs, 2010 ; Pieper, 2015 ); liver (Munnell and Taylor, 1947 ; Van Bodegraven et al, 1998 ; Lain and Catalano, 2007 ...…”