Malaria in pregnancy

Abstract

This review article describes the epidemiology, pathological and clinical features offalciparum malaria infection in pregnancy. The effects of malaria in pregnancy on both mother and fetus vary greatly according to the immune status of the woman, which in turn is determined by her exposure to infection. Non-immune pregnant women are at a much greater risk of severe disease than non-pregnant women and are at three-fold greater risk of death if they do develop severe disease. Any woman with symptomatic malaria should be treated with great urgency, using the most effective anti-malarial drug available. Specific features of severe disease in pregnancy include: hypoglycaemia, severe anaemia, pulmonary oedema, hyperpyrexia and cerebral malaria. Any patient with signs of severe disease should be managed in an intensive care or high dependency setting.The effects of malaria on the fetus are discussed and current recommendations for treatment are outlined for clinicians in a developed country setting. Recommendations for advice to travelers are made and brief mention is made of treatment for non-falciparum malaria infections in pregnancy.