Leishmaniose visceral e gestação: análise de casos e transmissão vertical no município de Campo Grande, MS, Brasil

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Visceral leishmaniasis in the gestational period is a rare event, and case reports are valuable in helping to assess suitable ways of managing the disease in order to prevent complications to mothers and neonates. The purpose of the present study was to describe cases of visceral leishmaniasis in pregnant women in Campo Grande, the capital city of Mato Grosso do Sul, in southwestern Brazil, taking into account epidemiological risk factors and the rate of vertical transmission. Eleven confirmed cases were investigated of pregnant women diagnosed with the disease from January 2001 to December 2007. This was a cross-sectional, descriptive, retrospective, observational case series study. The mean age of subjects was 21  6 years, ranging from 16 to 36. As many as 18% were in their second pregnancy and 67% were in the second trimester of gestation. Mean gestational age was 26 10.4 weeks. Laboratory tests at admission yielded abnormal results, indicative of anemia (100%), thrombocytopenia (91%), reversed albuminglobulin ratio (63.7%), and pancytopenia. Survey of the parasite in bone marrow aspirate slides was the diagnostic method (72,7%), in association with the indirect fluorescent antibody test (IFAT). The drug of choice was amphotericin B in desoxycolate (53%) or liposomal formulation (47%). Among the cases investigated, one miscarriage occurred in the 17th week of gestation and one mother died after giving birth (9%). The presumed vertical transmission rate of visceral leishmaniasis was 27.3%. The study revealed the potential occurrence of transmission from mothers to neonates, with death and premature birth among the possible outcomespossibilities that underscore the need for early diagnosis, so that drug therapy and intensive follow-up can be instituted in order to prevent complications.

ASSUNTO(S)

pregnancy congenital transmission kala-azar transmissão vertical gestação visceral leishmaniasis leishmaniose visceral epidemiologia vertical transmission calazar

ACESSO AO ARTIGO

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