Falciparum malaria in pregnancy.

Malaria in pregnancy is one of the major causes of maternal morbidity and mortality worldwide and leads to poor birth outcomes. Chloroquin is widely used but falciparum resistance to this antimalarial agent and late presentation translate into persisting morbidity and mortality. Three cases of falciparum malaria resulting in maternal and fetal morbidity and/or mortality are reported. Case 1: A 30-year-old woman gravida 2 abortion 1 following 9 months of amenorrhea presented with highgrade fever and rigor. A physical examination revealed sensory alteration metabolic acidosis and hypoglycemia; a peripheral blood smear showed falciparum malaria with a parasitic index of 12% and an ultrasonographic examination confirmed intrauterine death. Treatment with parenteral quinine and oral doxycyline was initiated. Labor was induced and the patient was delivered of a macerated female fetus. She was given an exchange transfusion because of her high parasitic index but died of cardiorespiratory arrest on the day following admission. (excerpt)