Human Placental Schistosomiasis—A Systematic Review of the Literature
Jacob Gerstenberg,
Sasmita Mishra,
Martha Holtfreter,
Joachim Richter,
Saskia Dede Davi,
Dearie Glory Okwu,
Michael Ramharter,
Johannes Mischlinger,
Benjamin T. Schleenvoigt
Affiliations
Jacob Gerstenberg
Institute for Tropical Medicine, Eberhard-Karls University Tübingen, 72074 Tübingen, Germany
Sasmita Mishra
Department of Obstetrics and Gynecology, Heidekreis Klinikum, 29664 Walsrode, Germany
Martha Holtfreter
Tropical Medicine Unit, Department of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany
Joachim Richter
Institute of International Health, Global Health Center, Charité University Medicine, 13353 Berlin, Germany
Saskia Dede Davi
Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
Dearie Glory Okwu
Centre de Recherches Médicales de Lambaréné, Lambaréné 242, Gabon
Michael Ramharter
Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
Johannes Mischlinger
Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
Benjamin T. Schleenvoigt
Institute of Infectious Diseases and Infection Control, Jena University Hospital, Friedrich-Schiller-University, 07747 Jena, Germany
Background: Schistosome egg deposition in pregnant women may affect the placenta of infected mothers and cause placental schistosomiasis (PS). Histopathological examination of placental tissue is an inadequate detection method due to low sensitivity. So far, there has not been any systematic review on PS. Methods: We conducted a systematic literature search on PubMed, EMBASE, and Medline and included all publications that reported microscopically confirmed cases of PS, as well as the relevant secondary literature found in the citations of the primarily included publications. Results: Out of 113 abstracts screened we found a total of 8 publications describing PS with a total of 92 cases describing egg deposition of dead and/or viable eggs and worms of S. haematobium and S. mansoni in placental tissue. One cross-sectional study investigating the prevalence of PS and its association with adverse birth outcomes, found 22% of placentas to be infested using a maceration technique but only <1% using histologic examination. Additionally, no direct link to deleterious pregnancy outcomes could be shown. Conclusions: PS is a highly unattended and underdiagnosed condition in endemic populations, due to a lack of awareness as well as low sensitivity of histopathological examinations. However, PS may play an important role in mediating or reinforcing adverse birth outcomes (ABO) such as fetal growth restriction (FGR) in maternal schistosomiasis, possibly by placental inflammation.
