Intestinal Parasitic

Infections in Pregnancy
Keilmuan Dasar Kebidanan II
TA. 2023/2024

dr. Risya Mawahdah Sp.Par.K

Table of contents

01 02 03
Introduction parasite Magnitude of the
Basic Helminthology
infection problem in the pregnant
population
04 05 06
06
Risk factors for parasitic Effects of pregnancy Effects of intestinal
infections in pregnancy on parasitic infections parasitic infections in
pregnancy
 01
Basic
Helminthology
 About Parasites
A parasite is an organism that lives on or in a host organism and gets
its food from or at the expense of its host.

Protozoa

Main classes
of parasites
that can
cause
disease in
Ectoparasites humans Helminths

Source: Global Health, Division of Parasitic Diseases and Malaria

 Helminths

Helminths→ Large, multicellular

Like protozoa, helminths can be
Helminthology→ The science organisms that are generally
either free-living or parasitic in
that studies worms visible to the naked eye in their
nature
adult stages

Modes of transmission differ

between species: ingestion of
larvae in raw or undercooked
In their adult form, helminths
pork, beef, fish; swallowing
cannot multiply in humans
worm eggs in feces; through
insect bites; direct skin
penetration

Source: Global Health, Division of Parasitic Diseases and Malaria

 Helminths
helminths that are human parasites:
There are three main groups of

Flatworms (platyhelminths) – these include the

trematodes (flukes) and cestodes (tapeworms)

Thorny-headed worms (acanthocephalins) – the adult forms of these

worms reside in the gastrointestinal tract. The acanthocephala are
thought to be intermediate between the cestodes and nematodes

Roundworms (nematodes) – the adult forms of these worms can

reside in the gastrointestinal tract, blood, lymphatic system or
subcutaneous tissues.

Source: Global Health, Division of Parasitic Diseases and Malaria

 02
Introduction
Parasite Infection
 Infections more prevalent in low-
The World Health Organisation income countries → Poor
(WHO) → a quarter of the world’s Distributed widely → Mostly in sanitation, increasing global
population or 1.5 billion people sub-Saharan Africa, the trade in food and travel →
across the world suffer from Americas, China and East Asia Increase in the risk of acquiring
intestinal parasitic infections certain parasitic infections
anywhere in the world

Women may be especially Serious consequences in

vulnerable to infections by food pregnancy → anaemia, low
borne parasites→ role in weight gain, impaired fetal
childcare, household work and growth, preterm birth and
food preparation maternal mortality

Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol. 2020
 03
Magnitude of The
Problem in The
Pregnant Population
 24 %–70 % of pregnant women have intestinal parasitic
infections → a tenth have infections with more than one
type of parasite

The most common parasitic infections worldwide→

Amoebiasis, ascariasis, trichuriasis and hookworm
infection

Among pregnant women→ the most common parasitic

infections→ Ascariasis followed by Hookworm infection

Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol. 2020
 04
Risk Factors for
Parasitic Infections
In Pregnancy
 Studies from Ethiopia → positive
association between intestinal
Poor socio-economic status, poor parasitic infections in pregnancy
sanitation, lack of access to clean with illiteracy→ lack of access to
water and poor hygiene habits sanitary toilet facilities and
consumption or raw and
unwashed fruits and vegetables

In pregnancy→ age and parity →

possible risk factors →Hookworm
Studies from Ghana, Colombia
infection→ in younger pregnant
and Papua NewGuinea→ living
women less than 29 years of age
with an infected partner; all of
and the prevalence declines from
which may relate to
primigravida to second gravida
socioeconomic conditions
before rising again for
multigravidae
Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol. 2020
 Risk factors for Intestinal nematode infections
among pregnant women

Alli JAet al Adv. Appl. Sci. Res., 2011

 05
Effects of pregnancy
on parasitic infections
 Pregnancy → Complex immunological changes →
Increase susceptibility to infections

The initial response to helminth invasion in

pregnancy is predomi-nantly cellular→ activation
of eosinophils, basophils and mast cells

Parasites live → depriving the host of nutrients and

some may interfere with the absorption of these
nutrients
Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol. 2020
 06
Effects of Intestinal
Parasitic Infections
in Pregnancy
Life Cycle of Taenia sp.
Life Cycle of Ascariasis
Life Cycle of Scisthosoma sp.
 Frequency of occurrence of intestinal nematodes in 152
positive stool samples and the co-infections

Alli JAet al Adv. Appl. Sci. Res., 2011

Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol. 2020
Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol. 2020
 Effects of soil-transmitted nematodes during pregnancy

Blackwell AD. Helminth infection during pregnancy: insights from evolutionary ecology. Int J Womens Health. 2016
 Effects of filarial nematodes during pregnancy

Blackwell AD. Helminth infection during pregnancy: insights from evolutionary ecology. Int J Womens Health. 2016
 Effects of Schistosoma during pregnancy

Blackwell AD. Helminth infection during pregnancy: insights from evolutionary ecology. Int J Womens Health. 2016
Effects of Cestodes during pregnancy
Five varieties of tapeworms most often infect humans:
•T. saginata→ beef tapeworm→ infection is caused when patients
ingest undercooked beef that contains larval cysts.
•T. solium→ pork tapeworm→ infection occurs when patients eat
undercooked pork.
•D. latum→ fish tapeworm→ eat undercooked freshwater fish.
•H. nana → dwarf tapeworm→the only species of tapeworm that can
transfer from human to human.
•Echinococcus → Once ingestion takes place→ the larva can move
throughout the body causing cysts to form on the organs.

https://www.who.int/news-room/fact-sheets/detail/taeniasis-cysticercosis
 Effects of Cestodes during pregnancy
- In endemic regions (in Asia)→infected people may develop visible or
palpable subcutaneous nodule

- Neurocysticercosis → variety of signs and symptoms depending on the

number, size, stage, and location of the pathological changes → the host’s
immune response → can also be clinically asymptomatic

- Symptoms → chronic headaches, blindness, seizures (epilepsy if they are

recurrent), hydrocephalus, meningitis

- Symptoms caused by lesions → occupying spaces of the central nervous

system
https://www.who.int/news-room/fact-sheets/detail/taeniasis-cysticercosis
Helminth infections Premature birth and low birth weight

effects for infant

Perinatal mortality

Modulation of Infant immune

response

The evolutionary context of antigen

transmission and tolerance
Prevention
• Wash your hands and scrub under your
fingernails – particularly before eating, after
using the toilet or after changing nappies
• Bathe or shower every morning
• Rinse toothbrushes before using them
• Keep fingernails short
• Wash sleepwear, sheets and towels regularly
• Disinfect kitchen and bathroom surfaces
• Vacuum regularly and dust using a damp cloth
Thanks
03/11/2023