Effect of asymptomatic malaria parasitemia on the uterine and umbilical artery blood flow impedance in third‑trimester singleton Southwestern Nigerian pregnant women
Background: Asymptomatic malaria parasitemia (AMP) in pregnancy is a major public health issue in tropical countries and represents a vast percentage of malaria infection in pregnancy. It is nonsymptomatic, neglected from treatment but significantly affects uteroplacental and fetoplacental hemodynamic blood flow, with negative pregnancy outcome that includes miscarriages, preterm labor/delivery, low birth weight, and intrauterine fetal death. Doppler ultrasound is a reliable, non‑invasive, ionizing radiation‑free, and repeatable method in the assessment of uterine and umbilical arteries vascular flow dynamics and resistance in malaria parasitemia in pregnancy.
Materials and Methods: This comparative cross‑sectional study was conducted between June 2016 and January 2017 was to assess and compare the vascular flow of the uterine and umbilical arteries in healthy pregnant women with AMP and those without malaria parasitemia in the third trimester of singleton pregnancy using Doppler ultrasound.
Results: The mean uterine arteries Doppler indices were significantly higher in AMP than controls. The mean Doppler indices values for pulsatility index (PI), resistive index (RI), and systolic to diastolic ratio (SDR) were 0.85 ± 0.16, 0.59 ± 0.11, and 2.12 ± 0.17 for the subjects and 0.77 ± 0.09, 0.51 ± 0.06 and 2.05 ± 0.22 for the controls, respectively. These differences were statistically significant: PI was (P < 0.001; 95% confidence interval [CI]: −0.11, −0.051), RI was (P < 0.001; 95% CI: −0.10, −0.063) and SDR was (P = 0.01; 95% CI: −0.11, −0.015). However, the mean umbilical arteries PI and RI were not significantly different between subjects and the controls.
Conclusion: There were statistically higher uterine artery impedance indices in the third trimester among singleton pregnant women with AMP than controls. This study also showed that the uterine artery impedance indices increased with the severity of malaria parasitemia.
Keywords: Asymptomatic malaria parasitemia; Doppler flowmetry; impedance; singleton gestation; umbilical artery; uterine artery
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