[The value of anatomo-pathologic examination of the placenta in areas of endemic malaria and low socio-cultural levels].
OBJECTIVE
Determine the sensitivity of the pathology examination of the placenta as a screening examination for malaria and the consequences of this infection on prematurity and birth-weight.


METHODS
Eighty placentas were examined at the Mjunga, Madagascar dispensary at the beginning of the rainy season. The aspect of the placenta was compared with a malaria index and to malaria disease state as a function of parity and anti-malarial prophylaxis used by the mother as well as with the state of the infant.


RESULTS
Among the placentas examined, 41.3% were considered normal and abnormal or clearly pathological in 58.7%. Estimating the gestational age on the basis of the histological examination of the amniotic cells was in agreement with the gestational age calculated from the last cycle in 53 cases and in disagreement in 8 cases. The percentage of cases of malaria discovered by the pathology examination (20%) was greater than that after thick swab screening (10%). 75% of the mothers has Plasmodium falciparum infection at the time of delivery and 13.8% of the mothers with negative thick drops had malaria lesions of the placenta. The parity of infected mothers was similar to non infected mothers. All the premature newborns had pathological placentas included 12.5% with malarial lesions. 90% of the hypertrophic newborns had pathological placentas included 50% with malarial lesions. No case of congenital malaria was observed.


CONCLUSIONS
Pathology examination of the placenta is as sensitive as blood drop tests for screening for malaria. The histological examination of amniotic cells can give a good estimation of gestational age in developing countries.
Randrianjafisamindrakotroka
N S
NS
Département d'Anatomie Pathologique et de Cytologie-Histologie-Embryologie, CHU de Majunga, Madagascar.
Rakotomamonjy
J C
JC
Zafisaona
G
G
Rakotoarimanana
D R
DR
D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000469:parasitology / Q000473:pathology; D001724:Birth Weight; D003906:Developing Countries; D005260:Female; D005865:Gestational Age; D006801:Humans; D006984:Hypertrophy; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000469:parasitology; D008270:Madagascar; D008288:Malaria / Q000151:congenital / Q000175:diagnosis* / Q000517:prevention & control; D016778:Malaria, Falciparum / Q000175:diagnosis; D008403:Mass Screening; D010298:Parity; D010920:Placenta / Q000469:parasitology* / Q000473:pathology*; D010922:Placenta Diseases / Q000175:diagnosis / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000517:prevention & control; D012680:Sensitivity and Specificity; D012923:Social Class
Intérêt de l'examen anatomo-pathologique du placenta dans les zones d'endémie palustre et de faible niveau socio-culturel.