Malaria in pregnancy: clinical features and outcome of treatment.

Over two consecutive malaria seasons in 1987 and 1988, 37 patients were admitted to the Gonder College Hospital with malaria in pregnancy. In 10 patients the diagnosis was missed initially and delayed for up to 72 hours after admission. The differential diagnoses considered on first line included incomplete abortion, labour, postpartum haemorrhage, and fulminant hepatitis in pregnancy. Twelve patients (32.4%) died, five of these died undelivered. Fifteen pregnancies (40.5%) ended up in abortion, preterm delivery with early neonatal death and still birth. This study has shown that malaria in pregnancy can have different clinical manifestations that may mislead the physician. This may delay the diagnosis and initiation of treatment which may have a fatal outcome for both the mother and the baby.