Pregnant women are relatively more vulnerable to severe malaria infection. It may pose a serious threat to pregnant women especially during the first and second pregnancies. Malaria infection in pregnant woman increases the risks associated with pregnancy. It can also lead to premature birth, abortion, miscarriage and stillbirths. Some of the other possible implications include hypoglycemia, anaemia, acute respiratory distress syndrome and lung injury.
Treatment of Malaria during Pregnancy
Drug Treatment
Proquanil, chloroquine and quinine are safe drugs for dealing with malaria during pregnancy. With the exception of falciparum malaria (plasmodium strains) that is resistant to chloroquine, these three drugs are largely used for eliminating most of the malaria parasites. It is not advisable to take other antimalarial drugs in the course of pregnancy without evaluating the risk and benefits.
Multiple drug treatment protocols are useful in treatment of the drug resistant plasmodium strain. Oral artemether is an alternative drug for the multiple drug resistant falciparum malaria. According to the World Health Organization (WHO), artemether is not recommended in the first trimester of pregnancy but must not be withheld in cases where it can save the life of the mother.
Antimalarial Drugs that must be avoided during Pregnancy
It is not safe to take the following drugs during pregnancy. For some of them there is insufficient information available. So consult your doctor before indulging in any sort of self medication.
- Atovaquone/Proguanil.
- Doxycycline.
- Primaquine.
Intermittent Preventive Therapy (IPT)
Pregnant women must routinely undergo Intermitted preventive therapy (IPT) as a part of antenatal care. It reduces the risk of placenta malaria, low birth weight and anaemia.
IPT for pregnant women consists of administration of a single efficacious anti-malarial drug twice during pregnancy. It is best to use IPT as a preventive measure and the drug must be administered under supervision.
Intermittent preventive therapy (IPT) with the malaria drug, sulfadoxine-pyrimethamine is the best for pregnant women; it reduces the risk of placenta malaria by 52 per cent. The World Health Organization (WHO) has recommend sulfadoxine-pyrimethamine for pregnant women. The safety and efficacy of sulfadoxine on placental infections and severe maternal anaemia is evident from many studies.
Case Management of Malaria during Pregnancy
Malaria screening must be done as a routine part of antenatal care. Pregnant women who are running a fever along with symptoms such as loss of appetite, chills, headache and body pains might have malaria. One can go for a blood test in order to confirm the malaria infection.
One with severe malaria must be given emergency care by the medical expert. This includes administration of antimalarial drugs, blood transfusion and the other life saving measures under the supervision of a skilled medical practitioner.
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