RESUMO
Typhoid fever is rare in Europe, but well-recognized endemic disease in tropical zones. We report our findings in a series of 25 cases of typhoid fever during pregnancy observed in French Guiana and reviewed the literature on clinical signs, diagnosis and treatment. Salmonellea typhi causes septicemia of digestive origin that can cross the placenta resulting in chorioamniotitis. Maternal-fetal infection with S. typhi can lead to miscarriage, fetal death, neonatal infection, as well as diverse maternal complications. In order to avoid maternal complications and possible fetal transmission, treatment with ceftriaxone should be initiated as early as possible
Assuntos
Doenças Endêmicas , Complicações Infecciosas na Gravidez , Febre Tifoide , Aborto Espontâneo/microbiologia , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Resistência Microbiana a Medicamentos , Doenças Endêmicas/prevenção & controle , Doenças Endêmicas/estatística & dados numéricos , Feminino , Morte Fetal/microbiologia , Guiana Francesa/epidemiologia , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Testes de Sensibilidade Microbiana , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Febre Tifoide/diagnóstico , Febre Tifoide/tratamento farmacológico , Febre Tifoide/epidemiologiaRESUMO
Malaria is the most frequent infection world wide affecting pregnant women. The association of malaria and pregnancy sometimes has serious repercussions on the foetus and increases maternal morbidity. We report 143 cases of pregnant women infected by Plasmodium falciparum in French Guyana. The consequences on the fetus in this area, where the maternal premunition rate is low, are serious: the rates of prematurity, hypotrophy and stillbirth are 3 times higher among pregnant women infected by malaria. The consequences for the fetus are all more serious if the infestation is repeated or prolonged, the closer one is to delivery, and if the parity is low. The histologic study of the placenta shows a significant correlation between the placental infection and the fetal hypotrophy. We tried to detect in utero the consequences malaria infection has on the fetus: the presence of an echographic oligoamnios and alterations of the Doppler ratings would be predictive of deleterious consequences of malaria on the fetus. We emphasize the need for rapid treatment as soon as the attack begins, before serious placental lesions occur.