Malaria Flashcards
Define malaria in pregnancy.
Infection with Plasmodium parasite.
Most deaths are caused by P. falciparum, whereas P. vivax, P. ovale, and P. malariae generally cause a milder form of malaria.
What is the aetiology of malaria in pregnancy?
Bitten by mosquitoes which are carrying Plasmodium parasite.
What are risk factors for malaria in pregnancy?
Travelling to endemic areas
Vertical transmission
Summarise the epidemiology of malaria in pregnancy.
In the UK, the prevalence of imported malaria in pregnancy is unknown.
What are symptoms of malaria in pregnancy?
Fever or history of fever
Characteristic paroxysms of chills and rigors followed by fever and sweats may be described.
Fevers occuring at regular intervals of 48-72 hours may be caused by P. ovale, P. malariae or P. vivax infections.
Headache
Muscle pain
Nausea
Vomiting
Diarrhea
Cough
General malaise
What are signs of malaria in pregnancy?
Jaundice
Elevated temperature
Perspiration
Pallor
Splenomegaly
Respiratory distress
What investigations should be performed for malaria in pregnancy?
Giemsa-stained thick and thin blood smears
Rapid diagnostic tests (RDTs)
FBC
Clotting profile
Serum electrolytes, urea and creatinine
Serum LFTs
Serum blood glucose
Urinalysis
Arterial blood gas
What is the management for malaria in pregnancy?
Intravenous artesunate is the treatment of choice for severe falciparum malaria. Use intravenous quinine if artesunate is not available.
Use quinine and clindamycin to treat uncomplicated P. falciparum (or mixed, such as P. falciparum and P. vivax).
Use chloroquine to treat P. vivax, P. ovale or P. malariae. Primaquine should not be used in pregnancy.
What are complications associated with malaria in pregnancy? What is the prognosis for malaria in pregnancy?
Coma
AKI
Preterm Labour
FGR
Fetal heart rate abnormalities
Stillbirth
Uncomplicated malaria in pregnancy is not a reason for induction of labour
All neonates whose mothers developed malaria in pregnancy should be screened for malaria with standard microscopy of thick and thin blood films at birth and weekly blood films for 28 days.
