Maryam M., 21

Maryam Mati is a 21-year-old pregnant woman (G₂P₁₊₀) at 38 weeks of gestation and a mother of one. She is married to a farmer, and they live in a two-bedroom mud house in Amshi village with a family income of about 3,500 naira. She presented with a one-week history of high-grade intermittent fever associated with chills and rigors. After clinical evaluation and laboratory investigations, she was diagnosed with severe Plasmodium falciparum malaria complicated by severe secondary anemia.

Treatment and Recovery Maryam, a 21-year-old pregnant woman, was admitted with a diagnosis of severe malaria in pregnancy. She received prompt treatment with intravenous Artesunate, intravenous fluids, Paracetamol for fever, and hematinic supplements including Iron and Folic Acid to manage anemia and support her pregnancy. Throughout her admission, she was closely monitored and received supportive care. Her fever gradually resolved, her strength improved, and her overall condition stabilized. Following successful treatment, Maryam recovered well and was discharged home in stable condition with medications and follow-up antenatal care instructions. She expressed gratitude for the medical care and support she received, which enabled her to recover and continue her pregnancy safely.

Maryam indicates a high-risk presentation of Severe Malaria in Pregnancy, further complicated by the failure of previous outpatient management. The history reveals that the patient sought care at multiple patent medicine vendors without clinical improvement, suggesting either a high parasite density that has surpassed the efficacy of oral ACTs (Artemisinin-based Combination Therapies) or the presence of drug-resistant Plasmodium falciparum strains. At this stage, the infection has progressed from uncomplicated to severe, rendering oral medication insufficient and necessitating immediate parenteral intervention. Prognosis Severe malaria in pregnancy is a critical medical emergency. Because pregnancy naturally suppresses the maternal immune response and allows parasites to sequester in the placenta, pregnant women are roughly three times more likely to develop severe disease than non-pregnant adults. The prognosis depends heavily on the speed of intervention and the quality of supportive care. Maternal Prognosis