Scribd Logo
Upload

Welcome to Scribd!

  • Malaria in Pregnancy

    Uploaded by

    yusuf
    5 views22 pages
    This document discusses malaria in pregnancy, which remains a major challenge. It causes significant risks to both mother and fetus, including anemia, low birth weight, stillbirth, and maternal death. The greatest threat is drug resistance. Symptoms vary but can include fever, headaches, and vomiting. Diagnosis is important to guide treatment. While several antimalarial drugs are generally safe in pregnancy like quinine and chloroquine, resistance has emerged, and some drugs like primaquine should be avoided. Effective treatment is still crucial to prevent complications, though more research is needed on safety and efficacy of various antimalarials during pregnancy.

    Original Description:

    Original Title

    Malaria in Pregnancy.pptx

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document discusses malaria in pregnancy, which remains a major challenge. It causes significant risks to both mother and fetus, including anemia, low birth weight, stillbirth, and maternal death. The greatest threat is drug resistance. Symptoms vary but can include fever, headaches, and vomiting. Diagnosis is important to guide treatment. While several antimalarial drugs are generally safe in pregnancy like quinine and chloroquine, resistance has emerged, and some drugs like primaquine should be avoided. Effective treatment is still crucial to prevent complications, though more research is needed on safety and efficacy of various antimalarials during pregnancy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views22 pages

    Malaria in Pregnancy

    Uploaded by

    yusuf
    This document discusses malaria in pregnancy, which remains a major challenge. It causes significant risks to both mother and fetus, including anemia, low birth weight, stillbirth, and maternal death. The greatest threat is drug resistance. Symptoms vary but can include fever, headaches, and vomiting. Diagnosis is important to guide treatment. While several antimalarial drugs are generally safe in pregnancy like quinine and chloroquine, resistance has emerged, and some drugs like primaquine should be avoided. Effective treatment is still crucial to prevent complications, though more research is needed on safety and efficacy of various antimalarials during pregnancy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 22

    MALARIA IN

    PREGNANCY
    Margaret Diana
    BACKGROUND
     Greatest challenge today is Resistance to Drugs
    CAUSES OF MALARIA
    CLINICAL FEATURES

    Symptomps Signs
    fever jaundice
    headache prespiration
    muscle pain pallor
    nausea splenomegali
    vommiting resp.distress
    diarrhea muscle pain
    cough
    malaise
    SEVERE CLINICAL FEATURES
    Severe haemolytic
    Cerebral malaria/
    Metabolic acidosis anaemia/black
    coma
    water fever

    Pulmonary
    Acute renal oedema / adult
    Hypoglycaemia
    failure respiratory
    distress syndrome

    DIC hypotension convulsions


    PROBLEMS
    Frequent

    Atipic

    Severe

    Fatal

    Selective theraphy

    others
    MATERNAL EFFECTS OF
    MALARIA
    Anaemia in pregnancy

    More common and severe young primigravidae

    Starts in mid trimester (16 – 24th w)

    Haemolysis and sequestration of infected RBCs into the RES.

    Haemolysis of non-parasitized RBCs

    TNF : Bone marrow suppression

    Loss of appetite
    FETAL EFFECTS OF MALARIA
    • Induction of uterine contractions
    Pyrexia • Abortions, preterm labour.
    • IUFD and fetal distress.

    • placental parasitization -> IUGR, LBW,


    Placental IUFD.
    • Placental Reaction : clogging of the
    Parasitization intervillous spaces with macrophages

    • Very rare
    Congenital • Fever, hepatosplenomegaly,anaemia,
    Malaria icteric
    • d/ blood smear
    IMMUNITY IN ENDEMIC AREAS
    • Low mortality rate
    • Mostly asimptomatic
    High
    immunity • Parasitemia rarely occured

    • Squesteration : LBW, Ab, IUFD, preterm,


    placenta
    • Placental malaria

    • Usually negative
    blood
    • Parasitemia : tm 2 & 3

    • Higher parasitemia
    1st & 2nd
    pregnancy
    PROTECTIVE MECHANISMS OF THE FETUS IN
    UTERO

    Immune mother transmit passive immunity


    (antimalarial IgG) to the fetus.

    The few parasites that succeed are destroyed by


    the antimalarial IgG

    The placenta greatly limits the number of


    parasites gaining access into the fetal circulation.

    Falciparum parasites do not grow well in fetal RBC


    containing Hb F.
    IMMUNITY IN NON ENDEMIC
    AREAS
    Higher
    Higher risk mortality
    rate

    Abortion Low birth


    >60% weight

    symptomatic
    DIAGNOSIS
    Importance
    • reduce unnecessary use of antimalarials.
    • High specificity
    Methods
    • Clinical diagnosis - low specificity
    • Detection of parasites in the blood.
    Parasitological diagnosis
    • Microscope
    • Rapid diagnostic tests (RDTs)
    ANTIMALARIALS IN PREGNANCY
    Quinine, chloroquine, proguanil,
    pyrimethamine and sulfadoxine–
    pyrimethamine.
    • quinine : the most effective & can be used in all
    trimesters of pregnancy including the first trimester.

    Amodiaquine, chlorproguanil- dapsone,


    halofantrine, lumefantrine and piperaquine
    • Have not been evaluated sufficiently to permit
    positive recommendations.
    Sulfadoxine–pyrimethamine

    • safe
    • ineffective in many areas -> resistance

    Primaquine and tetracyclines

    • Should not be used in pregnancy

    Despite these many uncertainties, effective


    treatment must not be delayed in pregnant
    women.
    THERAPHY : NON FALCIPARUM SP

    Cloroquin 25mg/kg
    Amodiaquin :
    effective but few datas
    agranulositosis

    Primakuin : RBC haemolisis


    FALCIPARUM
    Starts theraphy imidietly - asimtomatic

    Chloroquin : not efective

    Sulfadoxin-pyrimetamin

    Kuinin – clyndamicin : highly effective for


    multidrug ressistance -hipoglychaemia

    Artesunate 4 mg/kg : TM 2 & 3


    SEVERE MALARIA

    • No hipoglychaemia
    artesunate • 2-4mg/kg

    • Quinine 10 mg/kg
    quinine
    THANK YOU

    You might also like