The influence of maternal ketonuria on fetal well-being tests in postterm pregnancy

Although it is well-known that postterm pregnancies are associated with the risk of perinatal morbidity and mortality, a comprehensive study on its management is lacking. The aim of present study was to determine whether ketonuria is associated with abnormal fetal test results in pregnancies >40 weeks of gestation. In this analytical cross sectional study, a total of 360 pregnant women with gestational age of >40 weeks were evaluated in two hospitals during 2003 – 2004. For each woman, urinary ketones, glucose, pH, proteins, and specific gravity were measured by total screen LSG tapes (Rapignost); in addition, biophysical profile test was recorded and the amniotic fluid index was assessed by ultrasonography. Ketonuria was found in 34 women (9.44%). Statistical analyses showed that maternal ketonuria was associated with oligohydramnios, abnormal fetal tests, and a significant increase in fetal heart rate decelerations. Patients with clinically-detectable ketonuria have higher risk for abnormal fetal tests in comparison with those without the disease.