Severe malaria during pregnancy in the maternity ward of the communal medical centre of ratoma Guinea-Conakry

Abstract

Objectives :The objectives  were to describe the socio-demographic, clinical, paraclinical, therapeutic and prognostic characteristics of patients who developed severe malaria during pregnancy.
 Methodology: This was a prospective descriptive study carried out in the maternity ward of  Ratoma communal  medical centre over a  6 month period  from 01.10.2018 to 31.03.2019. 
Results: The incidence of severe malaria during pregnancy was 7%.  Our patients' average age  was 22.4  with extremes of 15 and 47  ; 15-19 and 20-24 age groups were the most affected ( 33.92% and 36.60%) . Primiparous women were the most affected (53.6%). The average parity was 3.2 .Very few patients (6%) used insecticide-treated mosquito nets (ITNs).Intermittent preventive treatment (IPT) with absorption in the second and third quarters of pregnancy of 3 tablets,  each containing 500 mg  of sulfadoxine and 25 mg pyrimethamine  was  reported in 23.5%. The mean gestational age  when the  severe malaria occurred  was 29 weeks .The symptomatology that motivated the consultation was variable ; the most frequent signs were: hyperthermia (100%), headache (79%), vomiting(99%).The general examination at admission  showed a fever with an average temperature of 39°C. All patients had a positive Rapid Diagnostic Test (RDT) and a thick drop. All patients received a parenteral quinine based treatment (100 After severe malaria, 70 patients (62.5%) carried their pregnancy to term and 40 delivered an eutrophic child (35.71%), 30 (26.78%) delivered a hypotrophic child, 20 (17.85%) had a spontaneous abortion, premature delivery was observed in 10 patients (8.9%), and a fetal death in utero was observed in 12 patients (10.71%). Maternal lethality was 1.8%.
 Conclusion: To improve this prognosis, intermittent preventive treatment should be further promoted as the most effective method of prevention at this time while awaiting a much hoped-for vaccine.