Some patients may have abnormal behaviour, convulsions, altered sensorium, sudden loss of consciousness etc. These symptoms of hypoglycemia may be easily confused with cerebral malaria. Therefore, in all pregnant women with falciparum malaria, particularly those receiving quinine, blood sugar should be monitored every 4-6 hours. Hypoglycemia can be recurrent and therefore constant monitoring is needed. In some, it can be associated with lactic acidosis and in such cases mortality is very high.
Maternal hypoglycemia can cause fetal distress without any signs.
It makes malaria more common and more severe. And to add to the woes, malaria itself suppresses immune response. Hormonal changes of pregnancy, reduced synthesis of immunoglobulins, reduced function of reticulo endothelial system are the causes for immunosuppression in pregnancy. This results in loss of acquired immunity to malaria, making the pregnant more prone for malaria. Malaria is more severe with higher parasitemia.