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Malaria in pregnancy.

Ebako Ndip Takem1, Umberto D'Alessandro

  • 1Medical Research Council Unit, Fajara, The Gambia.

Mediterranean Journal of Hematology and Infectious Diseases
|January 26, 2013
PubMed
Summary
This summary is machine-generated.

Pregnant women face increased malaria risk, leading to maternal anaemia, low birth weight, and mortality. This review updates knowledge on preventing and treating malaria in pregnancy (MiP) since 2000.

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Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Public Health

Background:

  • Pregnant women are more susceptible to malaria, particularly Plasmodium falciparum and Plasmodium vivax infections.
  • Maternal factors like young age, low parity, and early gestational age increase malaria risk during pregnancy.
  • Malaria in pregnancy (MiP) can cause maternal anaemia, low birth weight (LBW), preterm delivery, and increased mortality.

Purpose of the Study:

  • To provide an updated review of knowledge regarding Plasmodium falciparum and Plasmodium vivax infections in pregnancy since 2000.
  • To summarize maternal risk factors, effects, and pathophysiological mechanisms of malaria in pregnancy.
  • To outline current recommendations for diagnosis, prevention, and treatment of MiP.

Main Methods:

  • Literature review of studies published since 2000 on malaria in pregnancy.
  • Analysis of maternal risk factors, clinical effects, and placental sequestration mechanisms.
  • Evaluation of diagnostic methods, preventive strategies (ITN, IPTp), and treatment guidelines.

Main Results:

  • P. falciparum and P. vivax sequester in the placenta, mediated by specific surface antigens and receptors.
  • Mechanisms for preterm delivery and intrauterine growth retardation involve fever, anaemia, and elevated cytokines.
  • Microscopy sensitivity for MiP diagnosis is limited (60% peripheral, 45% placental); RDTs may be more reliable with poor microscopy quality.
  • Insecticide-treated nets (ITN) and intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) are effective prevention strategies.
  • Treatment guidelines vary by trimester, with quinine and clindamycin or ACTs recommended, and parenteral artesunate preferred for severe malaria in later trimesters.

Conclusions:

  • Malaria in pregnancy presents significant risks to both mother and infant, necessitating effective prevention and timely treatment.
  • Understanding placental sequestration mechanisms is crucial for developing targeted interventions.
  • Current prevention strategies like ITN and IPTp are effective, but treatment requires careful consideration of gestational age and drug resistance.
  • Accurate diagnosis and prompt initiation of appropriate treatment are vital for improving outcomes in malaria-infected pregnant women.