Low potassium or hypokalemia in pregnancy can be due to its loss from the body through diarrhea or vomiting. Low potassium levels in the blood can be associated with certain symptoms such as muscle cramps, constipation, weakness, and abnormal heart rates since they play vital roles in muscle and nerve functioning and blood pressure regulation (1).
If you are concerned about lower potassium levels, you may seek a doctor to undergo antenatal or fetal monitoring tests if needed. Read on to understand the consequences of low potassium levels in pregnancy, how to manage this, and when to seek medical care.
What Is The Normal Level Of Potassium In Blood During Pregnancy?
As per a study conducted on healthy pregnant women, the mean serum potassium concentration was found to be 5.65 millimoles per liter (mmol/l). The serum potassium level was 4.25 mmol/l in the first trimester, 5.83 mmol/l in the second trimester, and 5.95 mmol/l in the third trimester, which were considered normal (2).
If your serum potassium level falls below the normal level in any phase of your pregnancy, you may develop hypokalemia.
How Does Hypokalemia Affect Your Pregnancy?
Low potassium levels may lead to the following conditions in pregnant women.
- Weakness, fatigue, muscle cramps, and constipation (3)
- Hypokalemic periodic paralysis, which causes occasional bouts of muscle weakness in the legs, arms, and eyes (4).
- Cardiac dysrhythmia, an abnormal rhythm of the heartbeat that may cause cardiac arrest, one of the many obstetric emergencies (5).
Causes Of Low Potassium In Pregnancy
Low potassium in pregnancy might occur due to the following factors:
- Excessive nausea and vomiting: These can cause a fluid and electrolyte imbalance, resulting in potassium loss (6).
- Use of diuretics to treat high blood pressure: This could result in loss of fluids and urine, resulting in low potassium levels (7).
- Use of certain antibiotics: Antibiotics such as gentamicin and carbenicillin could deplete the potassium levels from the body (8).
- Increased production of aldosterone: Aldosterone plays a key role in regulating blood pressure during pregnancy. An increase in the level of aldosteroneiXA steroid hormone produced in the adrenal gland that regulates salt and water in the body. due to the hormonal changes during pregnancy could result in potassium excretion (9).
Symptoms Of Hypokalemia In Pregnancy
When the potassium level falls below the average level, you may experience the following signs and symptoms (10).
- Edema, mostly in legs and ankles
- NumbnessiXComplete or partial loss of feeling or sensation in the part of the body.
- High blood pressure
- Muscle weakness
- Leg cramps
Most of these are similar to pregnancy symptoms and can be diagnosed by testing the potassium level in your blood.
Diagnosis Of Hypokalemia In Pregnancy
Your doctor identifies the cause behind the loss of potassium. You may be asked if you recently had diarrhea, vomitings, and heart problems and if you were on antibiotics or diureticsiXAlso called water pills, these medications increase urine production by eliminating salt and water from the body. . If the doctor suspects you are hypokalemic, they may recommend the following tests:
- Blood tests to check the potassium level
- Blood pressure test as it is affected by hypokalemia
- ElectrocardiogramiXA display or record of the electrical activity of the heart. (ECG) to check the heartbeat (11)
Treatment For Hypokalemia In Pregnancy
- The treatment is usually directed towards improving maternal health by replenishing potassium in the body and minimizing further loss.
- The treatment depends on the underlying cause. For instance, if the condition is a result of morning sickness, addressing that issue helps. If hypokalemia is caused due to a specific medication (or maternal medications), you may be given an alternative medicine.
- The doctor may also prescribe potassium supplements, either oral or intravenous (in severe cases).
- Your doctor may recommend you to add potassium-rich foods to your diet. Although including potassium foods in your diet could be beneficial, it may be less effective than taking supplements (12).
Food Sources Of Potassium
According to the US National Academy of Medicine, the adequate intake (AI) for potassium in pregnant women ranges between 2,500 and 2,900mg depending on their age (13).
You can meet this requirement by eating foods such as beet, greens, baked sweet potatoes, spinach, avocado, tomato juice, plain yogurt, orange juice, mango, kidney beans, lentils, winter squash, dried peaches, coconut water, chicken, and salmon. You may check with your doctor or a nutritionist about the servings in the diet.
Alyssa, a soon-to-be mom, shares how she included mango and avocado in her pregnancy diet to ensure optimum potassium intake. She writes, “Aside from classically throwing these on sandwiches and into a big bowl of guacamole, I love to slice up a ripe avocado, sprinkle a little salt, and call it a snack. Healthy and delicious… Mangoes, like avocado, are a great source of potassium – a perfect treat to help battle any cramps or charlie horses (a nonclinical term for painful cramps in calf muscles)… I would just peel them and eat them raw. I also loooove mango in smoothies, or one of my favorite treats, coconut mango frozen yogurt (i).”
Can You Prevent Hypokalemia During Pregnancy?
The following measures may help in reducing the risk of hypokalemia on maternal and fetal health.
- Include a diet rich in potassium foods
- Increase electrolyteiXMinerals in the blood and other body fluids carrying an electric charge. intake.
- Manage conditions such as diabetes and blood pressure.
Can Low Potassium Levels Cause Miscarriage?
Low potassium levels are not known to cause miscarriage.
Frequently Asked Questions
1. Does low potassium cause preeclampsia?
No. In fact, according to a study, consuming low potassium may reduce the risk of hypertension in women with a history of pregnancy hypertensive disorders (14). Moreover, high potassium levels seem to be associated with the development of preeclampsia (15).
2. Is hypokalemia common in pregnancy?
Hypokalemia or low potassium levels in pregnancy is rare, occurring in about 1% of the healthy pregnancy population (16).
3. Can hypokalemia during pregnancy lead to complications such as preterm labor?
Potassium is an essential nutrient that helps run several psychological functions in your body. Persistent or excessive diarrhea and vomiting are some conditions when you can have a fluid loss, causing potassium deficiency. Low potassium or hypokalemia in pregnancy may lead to issues such as weakness, muscle cramps, and abnormal heartbeat. Therefore, prompt diagnosis and treatment of hypokalemia are vital to prevent maternal and fetal complications. In addition, eating a well-balanced diet, maintaining optimum electrolyte balance, optimal prenatal care, and maternal health education can help prevent potassium insufficiency or deficiency during pregnancy and achieve favorable neonatal outcomes.
Infographic: Dietary Management Of Hypokalemia In Pregnancy
Low potassium levels might lead to health issues, including muscle spasms, exhaustion, and cardiac problems in pregnant women. Therefore, you need to consume a diet rich in potassium while pregnant. This infographic lists common potassium-rich foods that can be easily included in the pregnancy diet.
- Hypokalemia may occur during pregnancy when the body loses electrolytes due to vomiting or diarrhea.
- Low potassium levels in pregnant women can be caused by excessive vomiting, diuretics, antibiotics, and increased aldosterone production.
- The potassium level in the blood varies during each trimester, with an average of approximately 5.65 millimoles per liter (mmol/l).
- Pregnancy-related hypokalemia can lead to heart arrhythmias, periodic paralysis, lethargy, cramps, and constipation.
- Hypokalemia in pregnancy can be treated by restoring potassium levels, addressing underlying issues, taking potassium supplements, and incorporating potassium-rich foods into the diet.
Personal Experience: Source
i. Pregnancy super foods;
2. Tomala J, Jendryczko A, and Kossowski; Serum potassium levels during pregnancy; Zentralbl Gynakol (1994).
3. Potassium; healthdirect.gov.au
4. Hypokalemic periodic paralysis; U.S. Department of Health and Human Services National Institutes of Health
5. Cardiac Dysrhythmia; Tufts Medical Center Community Care
6. Howard Ernest Herrell; Nausea and Vomiting of Pregnancy; American Academy of Family Physicians (2014).
7. Low potassium levels from diuretics; Harvard Health Publishing
8. Understanding hypokalemia; Nursing 2020 – The Peer-Reviewed Journal Of Clinical Excellence (2002).
9. Genevie`ve Escher;Hyperaldosteronism in pregnancy; Therapeutic Advances in Cardiovascular Disease; SAGE Journals (2009).
10. Potassium; University of Rochester Medical Center
11. Efstratios Kardalas et al.; Hypokalemia: a clinical update; Endocr Connect (2018).
12. Anthony J. Viera and Noah Wouk; Potassium Disorders: Hypokalemia and Hyperkalemia; American Academy of Family Physicians (2015)
13. The Nutrition Source – Potassium; Harvard T.H. Chan School of Public Health
14. Helmut K. Lackner et al. (2018); History of Preeclampsia Adds to the Deleterious Effect of Chronic Stress on the Cardiac Ability to Flexibly Adapt to Challenge.
15. Jong Hyun Jhee, et al.; (2019); Prediction model development of late-onset preeclampsia using machine learning-based methods; PLOS One
16. Charles B Businge, et al.; (2019); The prevalence and risk factors of Hypokalaemia among pregnant women in rural Eastern Cape South Africa Adapt to Challenge.
17. HYPOKALAEMIA; Fertilitypedia
18. Paresthesia; National Institute of Neurological Disorders and stroke
19. Hypokalemia in pregnancy; Patient Safety Oxford
20. Chien-Wen Yang, Si Li, and Yishan Dong; (2021); The Prevalence and Risk Factors of Hypokalemia in Pregnancy-Related Hospitalizations: A Nationwide Population Study; NIH
21. Jun-Mo Kim, Ki-Sung Song, Boqun Xu, and Tong Wang; (2020); Role of potassium channels in female reproductive system; NIH