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Chapter-20 Tropical Diseases in Pregnancy

BOOK TITLE: Essentials of Obstetrics

Author
1. Chowdhury NN Roy
ISBN
9788180613623
DOI
10.5005/jp/books/10288_20
Edition
1/e
Publishing Year
2004
Pages
9
Author Affiliations
1. Medical College, Kolkata, India
Chapter keywords
viral hepatitis, malaria, pregnancy, maternal and perinatal deaths, cerebral malaria, pulmonary edema, renal failure, anemia and hypoglycemia, fetal problems, abortion, preterm labor, IUGR, IUFD, congenital malaria, drug-resistant falciparum malaria, chronic infections, liver, kidneys, gastrointestinal disease, tuberculosis, maternal anemia, perinatal mortality, maternal mortality, fatal postpartum hemorrhage, monitoring of uterine contractions, fetal heart rate, fetal distress, chloroquine sensitivity, chloroquine, amodiaquine, prophylaxis (suppression), maternal deaths in jaundice, hepatic failure, postpartum hemorrhage, coagulation failure, bacterial (leptospirosis), protozoal (amoebiasis) infections, hepatitis A (HAV) infection, fecal-oral route, hepatitis B virus (HBV), serum hepatitis, IV drug users, blood transfusion, immunoprophylaxis

Abstract

Viral hepatitis and malaria during pregnancy cause large number of maternal and perinatal deaths globally. Maternal complications include cerebral malaria, pulmonary edema, renal failure, anemia and hypoglycemia. Fetal problems include abortion, preterm labor, IUGR, IUFD and congenital malaria. Drug-resistant falciparum malaria is dangerous. Chronic infections also damage important organs such as liver, and kidneys. Migration to urban slums increases the risk of gastrointestinal disease and tuberculosis. Maternal anemia is associated with perinatal mortality, maternal mortality and increased danger of fatal postpartum hemorrhage. Monitoring of uterine contractions and fetal heart rate may detect fetal distress at an early stage. In areas of chloroquine sensitivity, chloroquine or amodiaquine is to be used for prophylaxis (suppression) or for treatment. Common causes of maternal deaths in jaundice are hepatic failure and postpartum hemorrhage due to coagulation failure. Jaundice in pregnancy may also follow bacterial (leptospirosis) and protozoal (amoebiasis) infections. Hepatic failure excessively occurs in the 3rd trimester. PPH and coagulation failure are common complications of 3rd stage of labor. Hepatitis A (HAV) infection in developing countries is also due to its spread by fecal-oral route through contaminated food and water. Hepatitis B virus (HBV)—serum hepatitis is seen among IV drug users, and through blood transfusion. Immunoprophylaxis should be seriously considered for both mother and newborn baby.

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