• Shruti GOCHHWAL

Malaria and Pregnancy

When a pregnant woman suffers from malaria, it is harmful to both, the mother and the developing fetus with numerous symptomatic complications and even permanent complications in biological health.

Pregnant women are at a higher risk of malaria and are three times more likely to suffer from this disease as compared to a non-pregnant woman.

Although the reason behind this is not clear, researchers believe that it is due to reduced immune response and action in pregnant women to fight off such infections. This is because during pregnancy, your body in a way tries to suppress the immune system but not in the traditional sense. Changes are made to the mother’s immune system so that her body will be able to support her and the baby. This state makes her more susceptible to pathogens like bacteria, viruses, and parasites.

In fact, pregnant women contribute to a significantly large amount of malaria cases and contribute to 80% of malaria deaths in Africa.

Pregnancy Complications Due to Malaria

They include:

Problems in the newborn/developing fetus:

  1. Miscarriage

  2. Premature delivery

  3. Low birth weight

  4. Congenital infection

  5. Perinatal death

Problems with the mother:

  1. Anemia

  2. Fever illness

  3. Hypoglycemia

  4. Pulmonary edema

  5. Puerperal sepsis

  6. Cerebral malaria

Baby cry

In addition to undergoing immunological changes, pregnant women also undergo changes in the level of the hormones in the body. As a result, the presence of the malarial parasite in the blood tends to increase by 8 to 9 times. This is why malaria is one of the major causes of poor birth outcomes.

Due to these complications, malaria tends to be more dangerous and fatal in pregnant women with mortality being double compared to the rest of the population.

The parasite is capable of attaching itself to the cells of the placenta and interferes with the transmission of oxygen and nutrition to the developing fetus. As a result, the fetus will not receive all the nutrition and oxygen supply that it needs to form a fully healthy baby with no complications. It also causes general hemorrhaging.

Treatment

The reason why treatment of malaria in pregnant women is difficult is because it includes severe negative side-effects especially in cases of P. falciparum malaria.

Moreover, due to the various physiological and biological changes in the body, it is very difficult to effectively manage symptoms and continuously adapt to the hormonal changes while ensuring that the health of the fetus is not compromised at the same time.

Generally, there are many antimalarial and antiprotozoal drugs that are safe for the mother and the developing baby. Although they may have some side effects, eventually they are effective and advisable as the benefits outweigh the risks or side effects of prolonged infection.

malaria drugs

Studying the nature of parasite for treatment, Image Credit: Health mil


Chloroquine or Hydroxychloroquine is a good form of treatment for women diagnosed with malaria caused by P. Vivax, P. Ovale, P. Malaria that causes uncomplicated malaria and no severe symptoms.

For uncomplicated malaria caused by parasites that are resistant to the above drugs like chloroquine-resistant P. Falciparum, artemether-lumefantrine is used for the treatment of pregnant women in their second and third trimesters and mefloquine is recommended for all trimesters.

Although Doxycycline and tetracycline are not generally used or recommended for pregnant women, it is used in rare cases as a combination drug with quinine to treat patients when the parasite is resistant to other drugs or other treatment options are not available.

The treatment for severe malaria is more a complex and complicated process. There is no one single form of treatment and is usually decided by the doctor with thorough examination and analysis. Most of the treatment will greatly affect the health of the fetus.

consultation

Treatment and prevention, Image Credit: pxfuel


Prevention

Intermittent preventive treatments can be aimed to prevent or reduce malaria episodes. WHO recommended this treatment as a preventive measure that can be taken as early as possible in the second trimester of pregnancy.

A pregnant woman will generally receive at least three doses of this treatment during her entire pregnancy, with each dose received 30-35 days apart.

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