Information About Malaria In pregnancy
We Have to Know about the Malaria In pregnancy
- It is an infectious disease caused by protozoan Plasmodium which is transmitted to humans by the female Anopheles mosquito.
Overall distribution : P.Vivax – 70%
- P. Falciparum – 25-30%
- P. Malaria – 1%
- P.Ovale – rare
Malaria is more common in pregnancy when compared to the general population due to hormonal, immunological, hematological changes in pregnancy. Sequestration of parasites in the placenta with long-standing malaria occurs. And peripheral blood may still be negative for parasites. Higher parasitemia in the last two trimesters anemia and altered placental integrity results in abortion, stillbirth, premature births, low birth weight infants, excess infant mortality and morbidity. These problems are more common in first and second pregnancies as the parasitemia level decreases with increasing number of pregnancies.
Signs and Symptoms of Malaria In pregnancy
- Fever- Different pattern of fever, from a febrile to continuous fever and low grade to hyperpyrexia
- Anaemia due to haemolysis of parasitized RBCs. It can develop suddenly in severe malaria. It increases perinatal mortality and maternal morbidity and mortality
- Lactation is not contraindicated in malaria
- Secondary infection, UTI, Pneumonia, septic shock are common in pregnancy due to immune suppression
- Acute Pulmonary Oedema
- Splenomegaly, Jaundice, Convulsions, Vomiting, coma, altered sensorium.
- Hypoglycemia is more common in pregnancy due to increased response to pancreatic Islets secreting more insulin.
- Tachycardia, sweating, giddiness, abnormal behavior
- Peuperum – Latent infection because of the stress of labor.
Risk Factors of Malaria In pregnancy
- High-grade fever, Placental insufficiency, hypoglycemia, anaemia
- Prenatal mortality is 15-70%
- Premature births, stillbirths, abortions, IUGR, low birth weight, foetal distress.
Diagnosis of Malaria In pregnancy
- Demonstration of parasites in puerperal blood
- A dipstick test for falciparum antigen
- USG – for Splenomegaly, Hepatomegaly
- X-ray chest for Pulmonary edema
- Renal Function Tests
- PCR test for quick diagnosing.
Treatment for Malaria In pregnancy
- Refer to physician and obstetrician for management.