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Malaria in Pregnancy
Malaria is a parasitic infection which is carried by mosquitoes and is the commonest cause of pyrexia in many parts of the tropics. It is a serious disease but it is preventable.
It is caused by plasmodium parasites which are of 4 species:
Plasmodium Malariae, Plasmodium ovale, Plasmodium Vivax and Plasmodium Falciparum
In Nigeria, Plasmodium falciparum is the chief cause of malaria in adult. The vector is female Anopheles mosquito.
i. Fever which may be very high
ii. Rigors and sweating are common
iii. Headache and generalized malaise
iv. Gastro-intestinal disturbance e.g. vomiting and diarrhoea
v. Jaundice in cases of excessive haemolysis
Admit the patient and put her on bed rest. Take observation i.e. the temperature, pulse and respiration and Blood Pressure. Incase of pyrexia, expose the patient, tepid sponge or fan the patient. Check the packed cell volume and do grouping and cross matching should incase she would need transfusion. If there is loss of appetite, give light nourishing fluid diet. Give prescribed anti malaria drugs e.g. chloroquine 4:4:2 and give accompanying haematinics and vitamins supplement. Give psychological care to alley patient’s fear and explain cause and course of treatment. Teach the patient how to prevent re-occurrence. Advise on discharge:
· Use of mosquito net, cut surrounding bushes, drain gutters and washes regularly.
· Avoid stagnant water and, use daraprim.
Pregnancy has effect on malaria by decreasing acquired immunity to malaria mostly in 1st pregnancy but subsequent pregnancies do not.
· Hyperpyrexia caused abortion or premature labour or intrauterine death or macerated fetus
· Rapid destruction of red blood cells will cause haemolysis that lead to development of folic acid deficiency anaemia and jaundice.
· It causes parasitization of placenta,placenta insufficiency which leads to delivery of low birth weight babies.
· Cutting of surrounding bushes
· Use of mosquito treated net
· Drawing and washing of gutter
· Regular dusting of rooms
· Disinfection of pool
· Use of insecticides
· Prophylactic anti-malaria drugs
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