Key content: Lipid and triglyceride levels increase in pregnancy and do not pose problems for most women. However, pregnancy‐specific factors and genetic aberrations, especially mutations, may result in supraphysiological hypercholesterolaemia (HC) and severe hypertriglyceridaemia (sHTG). HC and sHTG are associated with complications in pregnancy, including acute pancreatitis, hyperviscosity syndrome and pre‐eclampsia. Abnormally high levels of lipids and triglycerides also affect fetal growth and the onset of gestational diabetes. The clinical presentation and diagnosis of HC and sHTG are varied. Management options include lifestyle and dietary restriction/modification, omega‐3, bile‐acid sequestrants, fenofibrate, statins and plasmapheresis. Learning objectives: To understand the physiological changes that occur in lipids in pregnancy and how these are modulated. To appreciate the importance of severe HC and HTG in pregnancy, including their effects on maternal morbidity and mortality. To understand the various approaches to management and the importance of multidisciplinary management. Ethical issues: Should every woman be screened for HTG and HC during pregnancy? How safe are statins and other treatments for lipid disorders in pregnancy? Should women with very severe HTG be discouraged from getting pregnant?

Since first reported in December 2019 in Wuhan, China, COVID-19 caused by Severe Acute Respiratory Syndrome (SARS) Corona virus2 (SARS CoV-2) quickly spread to become a pandemic that has caused significant morbidity and mortality. The rapidity of the spread of the virus and the high mortality at the outset threatened to overwhelm health systems worldwide, and, indeed, this significantly impacted maternal health, especially since there was minimal experience to draw from. Experience with Covid 19 has grown exponentially as the unique needs of pregnant and labouring women with COVID-19 infection have become more evident. Managing COVID-19 parturients requires a multidisciplinary team consisting of anaesthesiologists, obstetricians, neonatologists, nursing staff, critical care staff, infectious disease and infection control experts. There should be a clear policy on triaging patients depending on the severity of their condition and the stage of labour. Those at high risk of respiratory failure should be managed in a tertiary referral centre with facilities for intensive care and assisted respiration. Staff and patients in delivery suites and operating rooms should be protected by enforcing infection protection principles such as offering dedicated rooms and theatres to SARS CoV-2 positive patients and using personal protective equipment. All hospital staff must be trained in infection control measures which should be updated regularly. Breastfeeding and care of the new-born must be part of the healthcare package offered to COVID-19 parturient mothers.