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  6. Starvation ketoacidosis in pregnancy (1130)
Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. 

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number.  To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Starvation ketoacidosis in pregnancy (1130)

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Any cause of metabolic acidosis in pregnancy should be promptly recognised and managed in order to prevent fetal acidemia, hypoxia and intrauterine death. Severe metabolic acidosis in pregnancy is usually secondary to diabetic ketoacidosis, sepsis or rare metabolic conditions, but can be caused by starvation or poor nutrition.

Metabolic changes in pregnancy include increased insulin resistance, increased lipolysis and elevated level of free fatty acids which are driven by factors such as increased oestrogen and human placental lactogen. As a result, pregnant women are more susceptible to ketosis than non-pregnant patients and a relatively short period of starvation may precipitate ketoacidosis, particularly in the 2nd and 3rd trimesters when there is increasing insulin resistance with gestation.

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Editorial Information

Last reviewed: 14/12/2023

Next review date: 13/12/2028

Author(s): Katie McBride.

Version: 1

Author email(s): katherine.mcbride4@nhs.scot.

Approved By: Maternity Clinical Governance Group

Reviewer name(s): Katie McBride.

Document Id: 1130