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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malaria during pregnancy may be associated with significant morbidity and mortality in both mother and fetus. Treatment of severe chloroquine-resistant malaria during pregnancy may be problematic since quinine and related compounds may have a deleterious effect on the course of labor. This article reports the case of a 21-year-old primigravida Liberian woman who presented with high-grade (greater than 12%) parasitemia with Plasmodium falciparum. The patient was initially treated with chloroquine; however, she developed bilateral pulmonary infiltrates and premature labor, and her condition appeared to clinically deteriorate. Therapy was changed to intravenous quinidine, and red blood cell exchange transfusion was instituted. This resulted in a decreased parasitemia and clinical improvement. The patient underwent a cesarean section, and a healthy child was delivered. Although most cases of malaria may be managed with conventional chemotherapy, the use of intravenous quinidine in combination with exchange transfusion with careful monitoring should be considered in selected cases of severe, complicated malaria in pregnant women.
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PMID:Treatment of severe falciparum malaria during pregnancy with quinidine and exchange transfusion. 158 Mar 3

A study of the effects of malaria infection on the progress and outcome of pregnancy was carried out during 1987-88 in the Medical College Hospital, Surat, Gujarat. Pregnant women were highly susceptible to the infection (SPR, 57.7) compared to the general population (SPR, 18.6). P. falciparum infection was predominant (62.4%). The infection rate was also found to be higher (SPR, 72.2%) in second trimester compared to first and third semesters. Primigravidae seemed to be at a greater risk as the mean parasitaemia level was higher (39%) and the outcome poor as compared to multigravidae (29%). Infection during pregnancy caused severe maternal complications like abortion (9.7%), premature labour (59.6%), and still-births (5.7%), which were higher in P. falciparum infection. Microcytic anaemia combined with dimorphic anaemia was predominant in the infected group (89.5%). Cord blood in 4 cases and on baby's blood were found positive for malaria parasite, showing transplacental passage of malaria parasites, which is rare. The infection was found to have a definite bearing on the low birth weight of babies. Chemoprophylaxis could obviate much of the complications.
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PMID:Effects of malaria infection on pregnancy. 803 9

Poor quality medical care in some countries is an important concern, because of a lack of sterile equipment and lack of screening of blood products The safest time for travel is 18-24 weeks--after the risk of miscarriage and unpleasant nausea, but before problems such as premature labour Women with a previous history of miscarriage or ectopic pregnancy should be advised against travelling to countries where medical care is poor After 28 weeks a doctor's letter may be required before an airline will allow a pregnant woman to fly On board an aircraft, pregnant women should walk around the cabin at least once an hour to minimise the risk of deep vein thrombosis Malaria in pregnancy can be severe for both mother and fetus: chloroquine and proguanil have a long safety record Mefloquine is contraindicated in the first trimester and doxycycline should be avoided during pregnancy.
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PMID:Pregnancy and travel. 945 Apr 66

Anemia in pregnancy continues to be a serious problem in many developing countries, with significant adverse effects for both mother and infant. This article summarizes the available literature on anemia in pregnancy in developing countries, with emphasis on prevalence, etiology, and consequences. Prevalence data, especially from rural populations, are inadequate and little effort has been made to establish local etiologic patterns. Although emphasis has been placed on the role of nutritional deficiencies (especially iron) in anemia, the etiology is likely multifactorial. The relative contribution of etiologic factors such as iron and folate deficiencies, hemoglobinopathies, and malaria and hookworm infestation vary by geographic region and season. Anemia in pregnancy has been associated with increased risks of premature labor and low birth weight. There is an immediate need to assess more carefully the local etiologic factors and then design new strategies for prevention and treatment.
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PMID:Anaemia in pregnancy in developing countries. 960 57

In 1993, 2,008 deliveries were recorded at the Provincial Maternity Hospital at Franceville in Gabon. The frequency of cesarean section was 3%. The perinatal mortality of children born by cesaraean section was high, 213 per thousand. The principal indications for cesarean section were the baby being too large to pass through the pelvis, bicicatricial uterus, breech presentation and toxemia during pregnancy. The maternal mortality rate was 200 per 100,000, similar to the rates of most African countries, and 75% of the women that died had undergone cesarean section. The mortality rate for cesarean section was high (4.9%), so the indications for cesarean section in underdeveloped countries are limited. Malaria was the principal reason for the hospitalization of pregnant women, because it is endemic and is a serious condition for pregnant women. The next most frequent causes of hospitalization were a high risk of premature labor and hyperemesis gravidarum, the frequency of which is high among pregnant African women, particularly those of West Africa. Toxemia in pregnancy was the fourth most important cause of hospitalization. The rate of cesarean section rupture was 2.5 per thousand. Only 20% of these cases involved a cicatricial uterus, with no maternal deaths but a fetal mortality rate of 100%. The frequency of premature birth was 4.23% and the perinatal mortality rate was 48 per thousand, with 37 stillbirths per thousand and an early neonatal mortality rate of 11 per thousand. The perinatal mortality of breech presentations was high (330 per thousand), with 13.9 delivered by cesarean section. These levels are similar to those for other African countries. Maternal health could be improved by introducing several consultations during pregnancy, improving hospital hygiene and making antibiotics more widely available. Fetal survival could be improved by preventing premature births, providing more help with delivery, decreasing the time to intervention and improving neonatal resuscitation techniques.
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PMID:[Precarious situation of obstetric practice in Gabon]. 985 7

Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitute an important high risk group for malaria infection which may cause abortions, stillbirths, intra-uterine growth retardation (IUGR) and premature labour. In this hospital based study on 602 admitted patients of falciparum malaria which included 314 males, 243 non-pregnant females and 45 pregnant females, there was significantly increased mortality rate in females (18.4%) in comparison to males (7.64%, p < 0.001). The mortality rate was highly significant in pregnant females (37.77%) in comparison to non-pregnant females (14.81%) and males (7.64%; p < 0.001). Severe anaemia with Hb < 5 gm% was observed more commonly in pregnant patients (20.0%) in comparison to non-pregnant patients (4.11%). Incidence of malaria infection was more in primi gravida and second gravida. Pregnancy related complications in the form of preterm live births, intra-uterine death (IUD), still births and abortions were more in primi parous than multiparous patients. As the pregnancy is associated with increased incidence and adverse outcome of P.falciparum malaria infection, chemoprophylaxis should be made an integral part of antenatal care along with antianaemia therapy to reduce the risk of serious maternal and fetal complications.
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PMID:Mortality trends in falciparum malaria--effect of gender difference and pregnancy. 1077 20

The aim of the study was to identify maternal risk factors for perinatal asphyxia in Malawi. Records of 100 mothers who delivered neonates with Apgar scores less than 6 at 5 minutes of birth during March to September 1998 were analyzed. The majority of the mothers were primigravidas (79%) and were within the normal childbearing ages of 20 to 34 years (61.2%). Sixty-one percent of the mothers started antenatal care at 20 to 28 weeks' gestation. Sixty-five percent of the mothers developed obstetric and medical problems that contributed to perinatal asphyxia, and of these, 12 mothers (18.5%) had more than one problem. The problems were premature labor and delivery (21%), preeclampsia (10%), cephalopelvic disproportion (8%), breech presentation (12%), prolonged second stage (11%), fetal distress (7%), cord prolapse (4%), antepartum hemorrhage (2%), prolonged rupture of membranes (1%), and malaria (1%). Forty-six percent had assisted deliveries, and these were cesarean section (18%), vacuum extraction (14%), breech delivery (12%), and forceps delivery (2%). Eighty-one percent of the neonates were admitted to the neonatal nursery, and of these, 56 neonates (67.1%) developed complications; the most common was hypoxic ischemic encephalopathy (38 neonates; 67.9%). Thirty-three percent of the neonates died within 6 days postdelivery. Morbidity and mortality related to perinatal asphyxia can be reduced if staff are knowledgeable and skilled in basic neonatal resuscitation and necessary equipment is available. Mothers should be encouraged to report early for antepartum and intrapartum care for adequate surveillance. The quality of neonatal care, with a focus on thermoregulation and infection prevention, needs to be improved.
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PMID:Risk factors for perinatal asphyxia at Queen Elizabeth Central Hospital, Malawi. 1127 Nov 18

Congenital malaria is assumed to be a risk factor for infant morbidity and mortality in endemic areas like Maumere, Indonesia. Infected infants are susceptible to its impact such as premature labor, low birth weight, anemia, and other unspecified symptoms. The aim of this study was to investigate the prevalence of congenital malaria and the influence of mother-infant paired parasite densities on the clinical outcome of the newborns at TC Hillers Hospital, Maumere. An analytical cross sectional study was carried out in newborns which showed criteria associated with congenital malaria. A thick and thin blood smear confirmed by nested PCR was performed in both mothers and infants. The association of congenital malaria with the newborn's health status was then assessed. From 112 mother-infant pairs included in this study, 92 were evaluated further. Thirty-nine infants (42.4%) were found to be infected and half of them were asymptomatic. Infected newborns had a 4.7 times higher risk in developing anemia compared to uninfected newborns (95% CI, 1.3-17.1). The hemoglobin level, erythrocyte amount, and hematocrit level were affected by the infants' parasite densities (P<0.05). Focusing on newborns at risk of congenital malaria, the prevalence is almost 3 times higher than in an unselected collective. Low birth weight, anemia, and pre-term birth were the most common features. Anemia seems to be significantly influenced by infant parasite densities but not by maternal parasitemia.
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PMID:Congenital malaria in newborns selected for low birth-weight, anemia, and other possible symptoms in Maumere, Indonesia. 2554 15