We present a case of term pregnancy which presented with chief complaint of Breathlessness, chest pain as well as a one day history of vomiting. She tested positive for COVID19 through reverse transcriptase polymerase chain reaction of nasopharyngeal swab and the symptoms were attributed to Pneumonia caused due to COVID19.However,the arterial blood gas showed metabolic acidosis with high anion gap. This was a non lactate acidosis with no hypoxemia. Most reasonably the state of pregnancy with increased energy demands along with increased metabolic maternal demand due to infection coupled with maternal starvation had resulted in this Ketoacidosis . In view of non progression of labor caesarian section was carried out and a healthy neonate was delivered. There was an initial improvement in maternal ketoacidosis post partum however optimal management of COVID19 pneumonia required oxygen support and use of corticosteroids. Thus we highlight how an unusual metabolic demands of pregnancy might mimic COVID 19.

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Background: The most leading cause of perinatal and maternal deaths and morbidity in developed and developing countries like India is pregnancy related hypertensive disorders especially pre-eclampsia. PIH is defined as; in previously normotensive and normoproteinuric women, hypertension of >_ 140/90 mmHg with or without proteinuria measured on two occasions 6 hours apart after gestational age (20 weeks).Women with pregnancy related hypertensive disorders experience varied and altered lipid changes.    Increased TG, low-density lipoprotein cholesterol (LDL-C), cholesterol and decreased high-density lipoprotein cholesterol (HDL-C) concentrations leading to dyslipidemia was found in majority of the studies. Aim: The study aims to evaluate predictor like maternal sr. lipid profile in 2nd trimester in pregnancy related hypertensive disorders. Objective: To evaluate the occurrence of normal maternal and altered maternal serum lipid profile serum lipid profile in 2nd trimester of pregnancy in pregnancy related hypertensive disorders and compare them . Materials and Methods: The design of the study will be prospective as well as observational conducted from September 2020 to august 2022 with an estimated sample size of 1000. Patients included were nnormotensive and non-proteinuric in second trimester (13-20 weeks of gestation). Subjects will be evaluated on the basis of preformed and pretested proforma consisting of history, clinical symptoms and presentation and investigations. Blood samples for serum lipid profile will be collected in plain bulb with aseptic conditions and analyzed at the biochemistry laboratory by enzymatic method. Expected Results: We expect that from our results, altered maternal serum lipid profile in 2nd trimester will be positively associated with pregnancy related hypertensive disorders.