Potential serious complications during pregnancy which need immediate referral.
Malaria
Malaria is an acute febrile illness which is an infection of the red blood cells caused by a parasite called Plasmodium (recall back to your communicable disease module about malaria) that is carried by certain kinds of mosquitoes. A mosquito sucks up the malaria parasites in the blood of an infected person when it takes a blood "meal", and then passes the parasites when it bites someone else. The parasites develop to maturity in the individual's red blood cells and millions of parasites collect in the placenta of a pregnant woman. Malaria can be more severe in women who are sick with other illnesses. It is more dangerous to pregnant women than other people.
A pregnant woman with malaria is more likely to develop anemia, have a miscarriage (spontaneous abortion of the fetus before 24 weeks of pregnancy), an early birth, a small baby, as well as a stillbirth (baby born dead after the 24th week of pregnancy) or to die herself (maternal mortality).
Symptoms and Signs of Malaria:
- Chills (feeling unusually cold, shivering) and rigours (intense periods of shaking lasting several minutes and up to 1 hour); this is often the first symptom of an attack.
- A headache and weakness often accompany the chills.
- Fever (raised temperature); the fever often follows the chills, and the temperature may go so high that the person suffers delirium (not being in her right mind, seeing or hearing things that are not real).
- Sweating as the temperature falls.
- Diarrhoea/vomiting may also be experienced in some cases.
- Muscle/joint pain is another common symptom.
Diagnosis of Malaria
Malaria can be diagnosed in two ways from the blood sample.
a) Microscopic examination of the blood sample: the blood sample is taken from the infected mother and processed in the laboratory by a trained health professional and the parasite is seen directly through the microscope.
b) Rapid Diagnostic test (RDT): This detects proteins produced by the parasite in the patient's blood. The test kits can be in the form of a dipstick, a plastic cassette or a card, which changes colour when exposed to a drop of blood from an infected person or forms a red line with respect to the type of parasites found in the blood (usually taken by pricking a finger with a sterile lancet). However, the test kits must be stored carefully and protected from humidity and high temperatures.Because you are expected to diagnose a pregnant mother using RDT, you are trained how this test can be performed in your communicable disease control module. Hence, refer to your communicable disease module for the treatment of malaria.
Prevention of Malaria:
Pregnant mothers should be counselled about:
- The use of bed if she doesn't have used it before.
- Environmental sanitation to control the breeding sites of the mosquitoes.
- Early treatment of the case.
