Changes in the structure of chorioamniotic membrane in patients with malaria in pregnancy.

Abstract

Malaria infection in pregnancy has adverse consequences for both fetal and maternal health. There is insufficient data on the effect malaria in pregnancy has on the structure of the chorioamniotic membrane. Our objective was to determine the structure of the chorioamniotic membrane in patients with malaria in pregnancy. Specimens of the chorioamniotic membrane from 58 women with malaria in pregnancy and 58 women without malaria in pregnancy were used for this study. Biopsies of the fetal membranes were obtained immediately after delivery and processed for light microscopy. They were stained using H & E. Photomicrographs were taken for morphological analysis and statistical analyses were performed using Statistical Package for Social Sciences (SPSS, Version 23.0, Chicago, Illinois). The independent-sample t-test and odds ratios were used to compare the appropriate values between the two groups at a 95% confidence interval. Photomicrographs of the chorioamniotic membrane showed histological alterations, including a change of amniotic epithelium to columnar and stratified types, epithelial delamination, extensive fibrin deposition, and leukocyte infiltration in women with malaria in pregnancy. Statistical analysis found significant differences in epithelial type (p-value 0.001, ×2=17.9), epithelial denudation (p-value <0.001, ×2=19.4) and extensive fibrin deposition (p-value of 0.02 and ×2=7.5) between the study groups. This study has demonstrated histological alterations in the chorioamniotic membrane in association with malaria in pregnancy. Further studies may be conducted to characterize chorioamnionitis in malaria in pregnancy and associations with adverse pregnancy outcomes.