Abstract
Pregnancy is a physiological state in women which creates significant alterations in energy metabolism to provide energy supply to the foetus. The maternal fasting glucose level would be less than that of a non-pregnant state and in contrast plasma ketones and free fatty acids levels are elevated, resulting in a state of accelerated starvation. These metabolic alterations place a pregnant woman at a higher risk of developing euglycaemic ketoacidosis. We report a rare case of euglycaemic ketoacidosis causing severe increased anion gap metabolic acidosis in a pregnant woman.