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Over-the-counter antacids linked to severe hypokalaemia in the context of threatened preterm labour
  1. Katherine Lattey,
  2. Sarah Quinn and
  3. Katherine O'Brien
  1. Department of Obstetrics and Gynaecology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
  1. Correspondence to Dr Katherine Lattey; kat.lattey{at}


A healthy multiparous woman presented at 35 weeks and 4 days’ gestation with threatened preterm labour on multiple occasions. An incidental finding of severe hypokalaemia (2.4 mmol/L) was detected on routine blood tests. The cause of this hypokalaemia was not initially obvious. It was eventually linked to overuse of over-the-counter antacids for pregnancy-associated heartburn. The patient was managed with parenteral and then oral electrolyte replacement which corrected a pH of 7.55, bicarbonate of 36.7 mEq/L and a base excess 13.1. In this case report we consider whether hypokalaemia could be linked to uterine irritability and threatened preterm labour, whether antacids were being abused in the context of an eating disorder and the importance of taking a full drug history.

  • obstetrics
  • gynaecology and fertility
  • pregnancy
  • drug misuse (including addiction)
  • unwanted effects / adverse reactions

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  • Contributors KO and SQ conceived the idea for the case report and KL wrote and researched the initial draft of the paper. All authors were involved in significant re-drafts of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.