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Schistosoma haematobium infection in pregnancy

1992; Elsevier BV; Volume: 50; Issue: 4 Linguagem: Inglês

10.1016/0001-706x(92)90066-7

1873-6254

Dominik Siegrist, P. Siegrist-Obimpeh,

Child Nutrition and Water Access

Due to the economical lack of safe drugs in a remote area of Ghana (Bawku District) to treat Schistosoma haematobium infection during pregnancy, the spontaneous outcome of the pregnancy in women with proved S. haematobium infection was compared with a control group (average hospital delivery). In a survey of 200 pregnant women, we found a prevalence of S. haematobium of 4.5%. From the original collection of 41 infected pregnant women we could follow 23 up to delivery. This group showed a higher number of preterm (less than 37 weeks) deliveries, 34.8% vs. 23.8% in the control group. The birthweights in term deliveries (greater than 37 weeks) were not significantly different (3012 g vs. 3103 g). In the preterm deliveries the birthweight was significantly lower in the infected group (1768 g vs. 2457 g, p less than 0.005).Human infection with Schistosome hematobium is common in the Subsahel region of Ghana. Between January 1987 and July 1988, a study was conducted of all pregnant women attending Bawku District Hospital Antenatal-Clinic (ANC), Bawku/Upper East Region (Subsahel-Savanna), Ghana, with complaints and S. hematobium detected in their urine. Pregnant women received iron and folic acid tablets and tetanus-immunization. The partograms of 500 consecutive deliveries in Bawku Hospital (1600 deliveries/year) in the same period were used to collect data for the control group. To estimate the prevalence of S. hematobium infection in pregnancy in Bawku District, 200 pregnant women with a healthy pregnancy were screened. In 9 cases (4.5%) S. hematobium eggs were found in the urine. In 197 cases, the urine test revealed that 51 had proteinuria, 38 had blood in the urine, and 19 women had proteinuria and hematuria. The values were 22-40% with an average of 30%. The hospital delivery analysis of 500 consecutive partograms of the control group showed an average gestation at delivery of 38 weeks, birth weight of 2.917 kg, birth length of 48 cm, and gravidity of 3.6. 41 pregnant women were infected with S. hematobium. One of them had a double-infection of S. hematobium an S. mansoni. Because of 18 drop-outs, the outcome of the pregnancy in 23 women was followed up to delivery. Preterm (37 weeks) deliveries were 34.8% in this group vs. 23.8% in the control group. The births weights in term deliveries (37 weeks) were not significantly different (3012 g vs. 3103 g). In the preterm deliveries, the birth weight was significantly lower in the infected group (1768 g vs. 2457 g, p0.005). The complaints leading to subsequent diagnosis of infection were in 28 cases dysuria, 17 hematuria, 8 waistpain, and 10 lower abdominal pain. In the hospital deliveries, there was one neonatal death in which case the diagnosis of S. hematobium infection was made at the time of the premature delivery.