Abstract
BackgroundDuring pregnancy, Plasmodium falciparum-induced malaria can cause placental lesions and intrauterine growth restriction (IUGR). There are few published studies on Plasmodium vivax-induced malaria in pregnancy. Ultrasound is an efficient method for evaluating foetal biometry and placenta. The present study aimed to investigate the occurrence of increased placental thickness, foetal biometry and the amniotic fluid via ultrasound in a cohort of pregnant women with vivax malaria in Manaus, Amazonas, Brazil.MethodsA cohort study was conducted among 118 pregnant women with vivax malaria and 191 pregnant women without malaria. Foetal biometry, placental thicknesses and the amniotic fluid were evaluated via ultrasound. Biometric data were distributed by the trimester in which the infection occurred and converted to Z scores. The results were compared between the groups.ResultsAmong pregnant women from the cohort, increased placental thickness was observed in ten women with malaria (8.5 vs 0%; p <0.001). The Z scores of biometric parameters were not statistically significant when comparing the groups or according to the time of infection. In ultrasound results of the 118 pregnant women with malaria, seven (6%) showed low foetal weight, two (1.7%) showed oligohydramnios and one (0.85%) showed foetal malformation. There was no significant difference when these variables were compared to those of the control group.ConclusionsThe placental thickness changes were significant but caused no foetal repercussions at birth. The ultrasound findings except placental thickness were similar in both groups, possibly because this is a low-endemic area and the pregnant women in the study were followed up in an active detection system that allowed early diagnosis and treatment of new malaria episodes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0627-1) contains supplementary material, which is available to authorized users.
Highlights
During pregnancy, Plasmodium falciparum-induced malaria can cause placental lesions and intrauterine growth restriction (IUGR)
Plasmodium falciparum-induced malaria can cause placental lesions and changes in foetal oxygenation that lead to neonatal impairments, such as intrauterine growth restriction (IUGR), decreased amniotic fluid, prematurity and brain injuries caused by hypoxia and intrauterine death [12,13,14]
The present study aimed to investigate the occurrence of changes in placenta, foetal growth and amniotic fluid volumes by ultrasound in a cohort of pregnant women with vivax malaria in Manaus, Amazonas, Brazil
Summary
Plasmodium falciparum-induced malaria can cause placental lesions and intrauterine growth restriction (IUGR). There are few published studies on Plasmodium vivax-induced malaria in pregnancy. Ultrasound is an efficient method for evaluating foetal biometry and placenta. The present study aimed to investigate the occurrence of increased placental thickness, foetal biometry and the amniotic fluid via ultrasound in a cohort of pregnant women with vivax malaria in Manaus, Amazonas, Brazil. Plasmodium falciparum-induced malaria can cause placental lesions and changes in foetal oxygenation that lead to neonatal impairments, such as intrauterine growth restriction (IUGR), decreased amniotic fluid, prematurity and brain injuries caused by hypoxia and intrauterine death [12,13,14]. Placental thickness has been associated with various maternal and foetal conditions, including infections (toxoplasmosis, rubella, cytomegalovirus, and other infections), diabetes, anaemia, and hydrops, while decreased placental thickness has been associated with pre-eclampsia, thyroid disease, placenta insufficiency and IUGR [21,22,23]
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