Abstract

Placental malaria is the primary mechanism through which malaria in pregnancy causes adverse perinatal outcomes.
Malaria in pregnancy poses a great health risk to mother and her fetus and results into complications, such as
abortion, still birth, intra uterine growth retardation, and low birth weight. The heavy infiltration of Plasmodium
falciparum-infected RBCs in the intervillous spaces of placenta seems to be responsible for all the complications
observed. Infected RBCs in the placenta cause an inflammatory environment with increase in inflammatory cells and
cytokines which is deleterious to the placenta. Increased inflammatory responses in the infected placenta result into
oxidative stress that in turn causes oxidative stress-induced placental cell death. Moreover, heat shock proteins that
are produced in high concentration in stressed cells to combat the stress have been reported in fewer concentrations
in malaria-infected placenta. Pathologies associated with placental malaria seems to be the effect of a change in
immune status from antibody-mediated immune response to cell-mediated immune response resulting into excess
inflammation, oxidative stress, apoptosis, and decreased heat shock protein expression. However, we also need to
study other aspects of pathologies so that better drugs can be designed with new molecular targets. The main
strategy to combat placenta malaria is intermittent preventative treatment in pregnancy; however, increasing drug
resistance threatens the efficacy of this approach. There are studies dissecting the inflammatory response to placental
malaria, alternative preventative treatments, and in developing a vaccine for placental malaria.