Helminth Infections in Pregnant Women

Jill E. Weatherhead, MD; Laila E. Woc-Colburn, MD, DTM&H

Disclosures

March 14, 2014

Lymphatic Filariasis

Lymphatic filariasis caused by W bancrofti and B malayi has a worldwide human prevalence of 120 million in regions of India, Southeast Asia, and sub-Saharan Africa.[4,13] More than 40 million infected people develop lymphedema and hydrocele. Chronic lymphedema or hydrocele can evolve into elephantiasis or enlarged, thick, rough, fissured limbs that are prone to secondary infection.[13]

Lymphatic Filariasis in Pregnancy

Similar to other helminth infections, lymphatic filariasis has been shown to have prominent symptoms in pregnancy affecting both the mother and the developing fetus.[1] In lymphatic filariasis, microfilariae invade regional lymph nodes in the pelvis, causing local inflammation. The severe inflammation can result in genital deformities of the vulva.[1,11]

Chronic infection leads to distortion of anatomy as well as secondary bacterial infections. This can be socially devastating for the mother. Furthermore, it has been postulated that infants born to mothers with filariasis during pregnancy can have hyporesponsiveness to infections in the future as an infant or child.[3]

Little is known about additional helminth infections, including ascariasis, trichuriasis, and onchocerciasis, affecting pregnancy. However, each organism has potentially devastating outcomes on the mother and the developing fetus. Given this potential, helminth infections during pregnancy warrant further investigation because the global impact could be massive.

Case Continuation

The 22-year-old woman from Malawi underwent laparotomy with left total salpingectomy and was found to have genitourinary schistosomiasis.

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