Placental Malaria

A 29-year-old gravida 2, primiparous woman in her thirty-fifth week of pregnancy presented to the emergency department with diffuse abdom-inal pain, fever, and chills for 2 days. She had arrived from Uganda 3 days prior. She developed irregular uterine contractions, and labor was induced with oxytocin. She delivered a healthy baby boy. Peripheral smear was negative for any parasites, but the placen-tal histology showed abundant ring forms consistent with Plasmodium falciparum parasitemia (Image A and Image B). Blood smears from the infant did not show malarial parasites. HIV serological testing was negative in the mother. Pregnant women are more susceptible to malaria than nonpregnant women.1 The prevalence of placen-tal malaria is higher in primigravid than multigravid women.2 In holo-endemic regions such as the sub