MALARIA DURING PREGNANCY AND IN THE NEWBORN

A 25 year-old primigravid woman developed chronic falciparum malaria at 23 weeks' gestation. Diagnosis was suspected on splenomegalia and haemolytical anaemia but without fever and confirmed by thin smears (Plasmodium falciparum) and serologic tests. She was successfully cured with chloroquine therapy. One week after her return from Cameroon, a 28 year-old woman was seen for malaria at 32 weeks' gestation. In spite of chloroquine therapy, foetal troubles appeared and a caesarean was performed. The newborn had an APGAR coefficient of 3 points and examination both of his blood films and the placenta revealed numerous trophozoites of P. falciparum. Chloroquine resulted in a rapid cure of the child. In endemic areas, parasitaemia is more frequent and dense during pregnancy, and especially in primigravidae. However, clinical symptoms remain rare because of acquired immunity. In case of no or loss of immunity, malarial infections are heavy and abortions are frequent. Congenital malaria is probably due to transplacental transfer of infected red blood cells of the mother. In endemic areas, the incidence is low due to the simultaneously transferred immunity. Emergency treatment is necessary because of life-threatening to both mother and child.