title: Ultrasound findings in pregnant women with uncomplicated vivax malaria in the Brazilian Amazon: a cohort study.
abstract: BACKGROUND
  During pregnancy, Plasmodium falciparum-induced malaria can cause placental lesions and intrauterine growth restriction (IUGR). There are few published studies on Plasmodium vivax-induced malaria in pregnancy. Ultrasound is an efficient method for evaluating foetal biometry and placenta. The present study aimed to investigate the occurrence of increased placental thickness, foetal biometry and the amniotic fluid via ultrasound in a cohort of pregnant women with vivax malaria in Manaus, Amazonas, Brazil.
  
  
  METHODS
  A cohort study was conducted among 118 pregnant women with vivax malaria and 191 pregnant women without malaria. Foetal biometry, placental thicknesses and the amniotic fluid were evaluated via ultrasound. Biometric data were distributed by the trimester in which the infection occurred and converted to Z scores. The results were compared between the groups.
  
  
  RESULTS
  Among pregnant women from the cohort, increased placental thickness was observed in ten women with malaria (8.5 vs 0%; p <0.001). The Z scores of biometric parameters were not statistically significant when comparing the groups or according to the time of infection. In ultrasound results of the 118 pregnant women with malaria, seven (6%) showed low foetal weight, two (1.7%) showed oligohydramnios and one (0.85%) showed foetal malformation. There was no significant difference when these variables were compared to those of the control group.
  
  
  CONCLUSIONS
  The placental thickness changes were significant but caused no foetal repercussions at birth. The ultrasound findings except placental thickness were similar in both groups, possibly because this is a low-endemic area and the pregnant women in the study were followed up in an active detection system that allowed early diagnosis and treatment of new malaria episodes.
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av Pedro Teixeira 25, 69040-000, Manaus, Amazonas, Brasil. mariannabrock@hotmail.com.|Universidade do Estado do Amazonas, Av Castelo Branco 1777, Manaus, Amazonas, Brasil. mariannabrock@hotmail.com.
authors.forename: Marianna F
authors.initials: MF
authors.lastname: Brock
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av Pedro Teixeira 25, 69040-000, Manaus, Amazonas, Brasil. espinosa@ndi.ufes.br.|Universidade Federal do Espírito Santo, Vitória, Espirito Santo, Brasil. espinosa@ndi.ufes.br.
authors.forename: Angélica E
authors.initials: AE
authors.lastname: Miranda
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av Pedro Teixeira 25, 69040-000, Manaus, Amazonas, Brasil. camila.chabm@gmail.com.|Universidade do Estado do Amazonas, Av Castelo Branco 1777, Manaus, Amazonas, Brasil. camila.chabm@gmail.com.
authors.forename: Camila
authors.initials: C
authors.lastname: Bôtto-Menezes
authors.affiliation: Universidade do Estado do Amazonas, Av Castelo Branco 1777, Manaus, Amazonas, Brasil. jorgeleao18@hotmail.com.
authors.forename: Jorge R T
authors.initials: JR
authors.lastname: Leão
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av Pedro Teixeira 25, 69040-000, Manaus, Amazonas, Brasil. flor.espinosa@gmail.com.|Instituto Leônidas e Maria Deane, FIOCRUZ Amazonas, R Terezina 476, 69057070, Manaus, Amazonas, Brasil. flor.espinosa@gmail.com.
authors.forename: Flor E
authors.initials: FE
authors.lastname: Martinez-Espinosa
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D005333:Fetus / Q000502:physiology*; D006801:Humans; D016780:Malaria, Vivax / Q000175:diagnosis / Q000473:pathology*; D010920:Placenta / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000473:pathology*; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D055815:Young Adult