Severe malaria in pregnancy

Severe P. falciparum is associated with substantially higher mortality in pregnancy than in non-pregnant women.

Severe malaria in pregnancy can be associated with:

  • Hypoglycaemia (more frequent)
  • Pulmonary oedema (more frequent)
  • Obstetric complications (common) 
  • Associated infections (common)
  • Premature labour
  • Stillbirth
  • Neonatal death

Severe malaria may also present immediately after delivery. Postpartum bacterial infection is a common complication in these cases.

Supportive care

  • Transfer to intensive care
  • Blood glucose should be monitored frequently
  • Obstetric help should be sought
  • Once labour has started, foetal or maternal distress may indicate an intervention, and the second stage might have to be shortened by the use of forceps, vacuum extraction or caesarean section.