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委内瑞拉南部妊娠合并疟疾的并发症。

Malaria in pregnancy complications in Southern Venezuela.

机构信息

"Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela.

Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.

出版信息

Malar J. 2021 Apr 15;20(1):186. doi: 10.1186/s12936-021-03728-9.

Abstract

BACKGROUND

Pregnant women are particularly vulnerable to malaria infections, increasing the risk of maternal-fetal complications, mainly in high-endemicity areas. However, few studies of malaria in pregnancy (MiP) have been carried out in Latin America, a region with low endemicity and transmission of both, Plasmodium falciparum and Plasmodium vivax. Despite the high malaria burden in Venezuela in the last years, no recent studies of MiP have been conducted. Hence, epidemiological and clinical characteristics of pregnant women with malaria in southern Venezuela are described herein.

METHODS

A retrospective study in pregnant women attending at the "Ruíz y Páez" University Hospital Complex, Bolivar state, Venezuela, was carried out between February and October, 2019. Epidemiological, clinical, and laboratory information was analysed.

RESULTS

Thirty-seven out of 52 pregnant women analysed were infected with P. vivax. Age ranged between 15 and 39 years, and adolescent pregnancies were common. Malaria infection was diagnosed mainly during the third trimester of pregnancy (63.4%). The distribution of symptoms and signs as well as clinical laboratory values was similar among Plasmodium spp. Although uncomplicated malaria was most frequent, 30% (13/52) had severe anaemia. A high proportion of studied women (44%) presented at least one complication during the pregnancy or delivery. Spontaneous abortion was recorded in four women, and three fetal deaths were observed. Six women had preterm delivery without any further complication.

CONCLUSIONS

A high prevalence of maternal-fetal complications was found in the studied population, highlighting the requirement for a careful medical follow up during the prenatal check-ups, which should include routinary malaria tests. Preventive measures as distribution of insecticide-treated mosquito net for pregnant women at risk should also be implemented. Those measures can help to reduce the negative impact of malaria on the newborn and mother.

摘要

背景

孕妇特别容易感染疟疾,这增加了孕产妇和胎儿并发症的风险,主要是在高流行地区。然而,在疟疾发病率和传播率都较低的拉丁美洲地区,针对妊娠疟疾(MiP)的研究很少。尽管近年来委内瑞拉疟疾负担很高,但尚未对 MiP 进行近期研究。因此,本文描述了委内瑞拉南部孕妇疟疾的流行病学和临床特征。

方法

在 2019 年 2 月至 10 月期间,对委内瑞拉玻利瓦尔州“Ruíz y Páez”大学医院综合大楼的孕妇进行了一项回顾性研究。分析了流行病学、临床和实验室信息。

结果

在所分析的 52 名孕妇中有 37 名感染了间日疟原虫。年龄在 15 至 39 岁之间,青少年妊娠很常见。疟疾感染主要在妊娠晚期(63.4%)诊断。间日疟原虫感染的症状和体征以及临床实验室值的分布相似。虽然以无并发症疟疾最为常见,但 30%(13/52)的孕妇患有严重贫血。在所研究的女性中,有 44%(23/52)至少在妊娠或分娩期间出现了一种并发症。有四名妇女发生自然流产,有三名胎儿死亡。六名妇女早产但无其他并发症。

结论

在所研究的人群中发现了很高的母婴并发症发生率,这突出表明需要在产前检查期间进行仔细的医疗随访,其中应包括常规疟疾检查。还应实施针对处于风险中的孕妇发放驱虫蚊帐等预防措施。这些措施可以帮助减少疟疾对新生儿和母亲的负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dddc/8051027/bfa32c9c3a55/12936_2021_3728_Fig1_HTML.jpg

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