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Appel, Carin C. MD; Myles, Thomas D. MD


Background Excessive ingestion of caffeine can induce hypokalemia, which affects the neuromuscular system and can lead to paralysis.

Case A 24-year-old woman, gravida 3, para 2-0-0-2 at 33 weeks' gestation presented with muscular paralysis and hypokalemia secondary to drinking 6 to 7 L of cola per day with little other oral intake. After potassium replacement and stopping caffeine ingestion, the symptoms resolved quickly.

Conclusion The physiologic changes of pregnancy might potentiate the effect of caffeine on serum potassium concentration.

Excessive caffeine consumption during pregnancy can result in hypokalemia and progressive neuromuscular paralysis.

Department of Obstetrics and Gynecology, Texas Tech University Health Science Center, Amarillo, Texas.

Address reprint requests to: Carin C. Appel, MD, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, 1400 Wallace Boulevard, Amarillo, TX 79106. E-mail:

Received September 22, 2000. Received in revised form November 29, 2000. Accepted December 12, 2000.

© 2001 The American College of Obstetricians and Gynecologists