Visceral leishmaniasis (kala-azar) and pregnancy.
OBJECTIVE
The aim of the present review was to close the gap in the approach to pregnant women with visceral leishmaniasis (kala-azar) by providing up-to-date information to obstetricians about physiopathology, epidemiology, vertical transmission, drugs and treatment during pregnancy.


BACKGROUND
Infection with Leishmania chagasi during pregnancy is rare and deserves special attention since little information is available regarding the occurrence of visceral leishmaniasis during gestational period and the real possibility of vertical transmission of this disease. Because specific areas in the world are endemic for the disease and considering the continuous growth of the population, cases of pregnant women with visceral leishmaniasis are becoming more frequent. Unfortunately, textbooks on infectious diseases do not include this specific group of patients, and studies in the literature on aspects related to pregnancy and visceral leishmaniasis are scarce.


CONCLUSIONS
Vertical transmission of leishmaniasis is possible and the institution of treatment is imperative in cases of pregnant women with kala-azar. Amphotericin B is strongly recommended as the first choice drug due to its fewer maternal-fetal adverse effects.
Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. eafigueiro@uol.com.br
Ernesto Antonio
EA
Figueiró-Filho
Geraldo
G
Duarte
Patrícia
P
El-Beitune
Silvana Maria
SM
Quintana
Tamara Lemos
TL
Maia
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000965:Antimony / Q000008:administration & dosage / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007898:Leishmaniasis, Visceral / Q000151:congenital / Q000517:prevention & control* / Q000635:transmission; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*
D000981:Antiprotozoal Agents; D000666:Amphotericin B; D000965:Antimony