Ever since the beginning of the Covid 19 pandemic in December 2019,the focus has been on studying the varying clinical symptoms and signs of the disease. A condition which has been alarmingly occurring in quite a number of patients, is a state of hypoxemia, of which the patient is blissfully unaware and does not have any symptoms of breathlessness or respiratory discomfort in spite of having low oxygen saturation levels. Hence the term coined for it-“happy hypoxemia”. So far, all the studies describing this condition have found it to occur in Covid 19 patients or in patients with some underlying lung pathology. Having a high risk pregnancy added on top of it makes it all the more complicated especially when the patient’s condition deteriorates rapidly as demonstrated by her blood parameters without the patient presenting with the corroborative symptoms. We are reporting a case of a pregnant woman with twin pregnancy and pregnancy induced hypertension who rapidly progressed to HELLP syndrome without having proteinuria along with features of peripartum cardiomyopathy and also had low Oxygen saturation levels (less than 72%) though she did not have any complaints of dyspnea, orthopnea, hemoptysis,chest pain, cough or peripheral oedema. She was tested for Covid 19 with RT PCR on 2 occasions a week apart and was found to be negative. Her recovery was also unexpectedly rapid and progressive.

 

Abbreviations: BP: Blood Pressure, PPCM: Peripartum Cardiomyopathy, HELLP: Hemolysis,Elevated Liver Enzymes, Low Platelets