An obese body habitus may interfere with diagnosis of potentially life‐threatening conditions. This report describes an obese woman who presented with acute hypoxemic respiratory failure and diffuse infiltrates. Her body habitus disguised her parturient abdomen and she could not provide a history because she was intubated and paralysed. Only after a urine pregnancy test was undertaken did it become apparent that she was pregnant and the diagnosis of pre‐eclampsia with pulmonary oedema was considered. Urine pregnancy tests are part of the standard work‐up for abdominal pain in women of childbearing age, but are not viewed as part of the work‐up for respiratory distress or diffuse radiographic infiltrates. This case illustrates the value of obtaining a pregnancy test in all women, particularly those with obese body habitus, who present with respiratory failure of unclear aetiology
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