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  • Title: Detection of elevated ketone bodies by postmortem 1H-MRS in a case of fetal ketoacidosis.
    Author: Heimer J, Gascho D, Fliss B, Martinez RM, Zoelch N.
    Journal: J Forensic Leg Med; 2018 Oct; 59():16-19. PubMed ID: 30067991.
    Abstract:
    We report a fetal loss following maternal ketoacidosis in a case of cryptic pregnancy. Biochemical analysis of peripheral blood revealed highly elevated levels of beta-hydroxybutyrate (BHB) in the mother (9.2 mmol/l) and the fetus (4.2 mmol/l). Fetal ketoacidosis with hypoxic-ischemic brain damage was determined to be the cause of death. 1H-MRS of the right cerebral hemisphere presented with distinctive resonances of BHB and acetone. Acetoacetate and glucose were not detected. Due to reported chronic abuse of ethanol and a period of fasting, alcoholic ketoacidosis was concluded to be the cause of the metabolic disorder. 1H-MRS is a viable examination for the postmortem detection of ketone bodies and may be a key supplement to noninvasive fetal autopsy for the diagnosis of ketoacidosis.
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