antimony-sodium-gluconate and Abortion--Spontaneous

To investigate maternal and perinatal outcomes when pregnant women with visceral leishmaniasis (VL, also known as kala-azar) are treated with the antimonial sodium stibogluconate.. Forty-two pregnant women with VL were treated with sodium stibogluconate at Gadarif Hospital, Gadarif, Sudan, and mother and child were followed up for 1 year.. The treatment began at a mean+/-SD of 24.4+/-9.2 weeks of pregnancy. None of the patients had malaria or HIV. Two (4.7%) who received the treatment in the first trimester had miscarriages; 4 (4.9%) died from hepatic encephalopathy during the second week of treatment; and 2 (4.7%) had preterm deliveries. One of the newborns had a myelomeningocele and died at 2 hours, and the other died from VL at 2 months.. Preventive measures against VL should be employed in the region, and more research on VL and its treatment during pregnancy is needed.

Topics: Abortion, Spontaneous; Adolescent; Adult; Antimony Sodium Gluconate; Antiparasitic Agents; Female; Humans; Infant, Newborn; Injections, Intramuscular; Leishmaniasis, Visceral; Pregnancy; Pregnancy Complications, Parasitic; Sudan; Young Adult

Little is known about the treatment of visceral leishmaniasis (VL) in pregnancy, especially in resource-poor settings. We present a series of pregnant women with VL treated with either sodium stibogluconate or liposomal amphotericin B (AmBisome), or both, in eastern Sudan over 16 months.. We did a retrospective analysis of all pregnant VL patients treated in the Médecins sans Frontières (MSF) Um el Kher centre between January 2004 and April 2005. We diagnosed VL with laboratory confirmation of clinical suspects, and recorded the outcomes of treatment for pregnant women and their foetuses. We carried out a manual search of relevant publications and a systematic search of the literature in the MEDLINE database.. We treated 23 women with sodium stibogluconate, 4 with AmBisome and sodium stibogluconate and 12 with AmBisome alone. There were 13 (57%) spontaneous abortions in the sodium stibogluconate monotherapy group, and none in either of the other two groups. All spontaneous abortions occurred in the first two trimesters. All patients, except one in the sodium stibogluconate group who defaulted, were discharged as cured in good clinical condition.. AmBisome treatment for VL appears to be safe and effective for pregnant women and their foetuses. We recommend the use of AmBisome as first-line treatment for these patients.

Topics: Abortion, Spontaneous; Adolescent; Adult; Amphotericin B; Animals; Antimony Sodium Gluconate; Antiprotozoal Agents; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Leishmaniasis, Visceral; Middle Aged; Pregnancy; Pregnancy Complications, Parasitic; Sudan; Treatment Outcome