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
vi.
Anaemia
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.
·
Spleenomegaly
·
Delirium,Convulsion,Coma.
·
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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