Malaria in Pregnancy

Reproductive System
Parasitology Dept.
Fakultas Kedokteran USU
Life Cycle of Plasmodium

HY 2
Malaria in Pregnancy
• One of malaria complications
• Severity is greater in pregnant woman
• Susceptibility is depended on pre-
pre-
pregnancy immunity
• In non-
non-immune women: similar in all
parities
iti
• In immune women: primigravidae are more
affected
ff t d
• May cause congenital malaria to the fetus

HY 3
Congenital Malaria
• May cause abortion and premature
delivery
• Signs
g & symptoms
y p include:
– Low birth weight
– Fever
– Jaundice
– Anemia
– Hepatosplenomegaly

HY 4
True Congenital Malaria
• Intra uterine infection
• Occurs thru placental barrier from
infected mother to fetal circulation
• Hepatocytes?
• How does it affect the baby?

HY 5
False Congenital Malaria
• Intra and/post partum infection
• Occurs during delivery thru blood
exchange g from maternal circulation to
fetal circulation
• Hepatocytes?
• What happens to the baby?

HY 6
Effects of malaria due to endemicity

Malaria endemicity
Effects of malaria
Low High
a) On the mother
Severe disease including -
++
death (indirect through anemia)

Acute disease/anaemia +++ (all parities) +++ (mainly primid)

Hypoglycaemia ++ ?
Placenta infection + +++ (mainly primid)
b) On the fetus
Abortion/perinatal death ++ ?
IUGR +++ (all parities) +++ (mainly primid)
Prematurity ++ ?
Congenital infection ++ +
HY 7
Malaria drugs in pregnancy
• Artemisin: trimester 2 and 3 in MDR
areas
• Chloroquin:
q all age
g of p
pregnancy
g y
• Quinine: all age of pregnancy
• Primaquin: contraindication
• Doxycycline: contraindication
• Tetracycline: contraindication

HY 8
Thank You

HY 9