Book of Medical Disorders in Pregnancy - Tintash

insect repellents and insecticide sprays.
The antibodies to malaria are contained
in the gammaglobulin fraction of the
serum protein, which can cross the
placenta readily. Newborns of
indigenous population, which have
acquired immunity, rarely develop
congenital malaria. The passive
immunity transmitted from the mother
lasts in the infant for about a month but
the antibody is highly specific for the
variety of parasite endemic in the area.
Treatment:
The newborn should receive chloroquine
hydrochloride intramuscularly with a
starting dose of 5.0 mg per Kg body
weight and then followed by 2.5 mg per
Kg of body weight at 8 hour intervals.
After control of the acute infection the
drug should be continued orally in single
doses of 60 mg daily for 4 days.
Fig12.3: -Shows structure of ameba.
AMEBIASIS:
Incidence - The incidence of amebiasis
bears a direct relationship to the level of
sanitation in a community. Human
beings acquire infection by ingestion of
amebic cysts which are present in water
and food. In developing countries such
157
as Pakistan the incidence of this disease
is much greater than in the developed
cou- ntries where the standard of sani·
tation is relatively better.
Clinical features: Most women who
have amebiasis have few or no
symptoms. The symptoms include
bloody diarrhoea, lower abdominal
cramps and anorexia. There is often
history of we-ight loss or no weight gain.
The infection may be acute or chronic.
Acute infection: There is prostration.
Dehydration, intestinal hemorrhage, and
anaemia. If perforation of the bowel
occurs diffuse peritonitis will result with
its serious consequences for the mother
as well as the baby.
Chronic infection: This is far more
common than it is realized and many
pregnant patients with low or no weight
gain may be suffering from this complication.
Genital infection: The vulva, vagina
and uterus can get involved when there
is contamination with ameba laden anal
discharge or from a rectovaginal fistula.
The genital lesions resemble carcinomatous
ulcers. Amebic skin ulcer may
be formed and is usually seen around the
anus and vagina.
Amebiasis of the geni-tal tract can be an
important cause of infertility. Peritonitis
and result in pelvic adhesions and tubal
occlusion. If blood vessels are invaded
by the parasite, the liver, lungs and brain
may get involved with abscess formation.
When liver abscess is present the patient
presents with fever, weight loss, upper
abdominal pain and an enlarged tender