Placental malaria. I. Pathological classification

Histopathology. 1993 Mar;22(3):211-8. doi: 10.1111/j.1365-2559.1993.tb00110.x.

Abstract

Pregnant women are more likely to contract malaria than their non-pregnant counterparts. The aim of this study was to develop a simple classification system for the histopathological diagnosis of placental malaria infection applicable to placentas collected in field conditions. The placentas were classified into four groups depending on the presence and distribution of parasites and malaria pigment: active infection, active-chronic infection, past-chronic infection, not infected. The frequency of parasitized placentas (26.4%) was in keeping with the prevalence of placental parasitaemia documented in epidemiological studies. An additional 29.8% placentas showed pigment in fibrin only, indicating past-chronic infection. Chronic placental malaria infection was most common in primigravidae, possibly reflecting ineffective clearance of parasites from the placenta. Seasonal fluctuations between infection categories support progression of placental infection with delayed clearance of pigment from fibrin. The proposed classification system has allowed diagnosis of different categories of placental malaria infection by two independent observers. A standardized method of diagnosis may enhance understanding of placental pathology and reduced birth weight in malaria infection during pregnancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Africa, Western / epidemiology
  • Animals
  • Antibodies, Protozoan / analysis
  • Birth Weight / physiology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fibrin / analysis
  • Humans
  • Immunoglobulin G / analysis
  • Immunoglobulin G / immunology
  • Immunoglobulin M / analysis
  • Immunoglobulin M / immunology
  • Incidence
  • Malaria, Falciparum / diagnosis
  • Malaria, Falciparum / epidemiology
  • Malaria, Falciparum / pathology*
  • Parity
  • Placenta / parasitology
  • Placenta / pathology
  • Placenta Diseases / classification*
  • Placenta Diseases / parasitology*
  • Placenta Diseases / pathology*
  • Plasmodium falciparum / immunology
  • Plasmodium falciparum / isolation & purification
  • Pregnancy
  • Pregnancy Complications, Parasitic / diagnosis
  • Pregnancy Complications, Parasitic / epidemiology
  • Pregnancy Complications, Parasitic / pathology
  • Seasons

Substances

  • Antibodies, Protozoan
  • Immunoglobulin G
  • Immunoglobulin M
  • Fibrin