Emergency Room Series: Malaria When Preggy

There's always a limit to what the body can take before it gives in. 

A woman in her mid thirties was brought to the ER. She was rushed in by her colleagues from her work place. She was said to have slumped and passed out at work and started bleeding from her vagina. she had been vomiting before passing out. She was in the mid stage of her pregnancy, about 4 months.


On admission, she had somehow gained consciousness. Her pulse was fast and her blood pressure was a bit low. She was so worried about her baby and kept asking if her baby was fine. 

We quickly passed IV fluids to rehydrate her and replace the fluids lost. She had medications to stop the vaginal bleeding. Her blood sample was taken to check her blood level along with tests for malaria, electrolyte count and others. The doctor was more concerned about the malaria test result. 

The gynaecologist came around and used a Doppler fetoscope to check for the fetal heart beat but wasn't getting any heart beat. She was immediately wheeled to the ultrasound room to check the condition and activity of the baby. 

The malaria test came out to be +++, which was severe for someone who is pregnant. As she got to the scan room, she was assisted to stand from the wheel chair and lay down on the scan couch. As she got up, the bleeding increased. 

We suddenly heard a thud. Gbam!. 

The baby dropped on the floor. It was the most terrifying thing I had ever seen. 

The patient screamed. I froze. There was so much blood everywhere. She was quickly put back on the wheelchair. The doctor quickly grabbed the foetus. I think he was trying to resuscitate the child or look for signs of life. I just stood there, staring at the baby with my heart pounding. The child was already pale, blue and with wrinkled skin which meant the child would have been dead for at least a day or two in her tummy. 

Right there in the scan room, we got the instruments for evacuation and asked for her consent, she was crying so much. She would lose more blood if the placenta and other fetal materials are not removed on time. She had the tissues removed and she was cleaned up and taken to the recovery room where she had two bags of blood. She also had pain medications and antibiotics. I stayed back to console her. We can only empathize and not sympathize. 

She was inconsolable. Her colleagues at the office sat with her on the bed. They were quite many and increased in number after office hours. I've not seen a lady cry that much. She asked God why He took her joy away. I learnt she hasn't had a child in her 10 year marriage. She must have been a very friendly and jovial person as there were a lot of people coming to see her. 

Usually we dont allow visitors into the recovery room but we allowed them to sympathize with her. We were told her husband was out of town.


Malaria in pregnancy is a very dangerous condition. If you have malaria while pregnant, you and your baby have an increased risk of developing serious complications, such as: premature birth – birth before 37 weeks of pregnancy, low birth weight, restricted growth of the baby in the womb, stillbirth, miscarriage or worse the death of the mother. 

It is important for pregnant women to avoid getting exposed to mosquitoes. Clean environment and drainage, use of mosquito net, regular malaria treatment are ways to avoid complications that arise from malaria. You should safeguard your health and that of your unborn child.

*OMG OMG::...this is so so sad but How come she didnt know that she had Malaria before t got so bad?Are there signs to look out for?can you tell us?