Malaria in pregnant women

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❖ Falciparum Malaria (FM)

a. Uncomplicated Malaria (UM):

Like non-pregnant woman with ACT in all trimester of pregnancy.
Alternate treatment will be 7 days of Quinine+ Clindamycin (Q7+ C7)

b. Severe Malaria (SM):

❖ IV Artesunate is preferred antimalarials for SM in all trimester of pregnancy

❖ IM Artemether can be given in all trimester if for any reason IV Artesunate can not be given.

❖ In absence of parenteral Artemisinin derivative, IVQ/IMQ (Alternatively) should be given. Loading dose of Quinine should be given

❖ Oral follow on treatment will be ACT full dose after IV Artesunate/IM Artemethar/IV Quinine treatment

❖ Vivax Malaria (VM)

  • Chloroquine 3 days (CQ3)

Chloroquine is safe in all trimester of pregnancy.

If the patient developed recurrent attack of vivax malaria, Chloroquine can be given in every episode of illness. Chloroquine is still highly sensitive and effective in vivax malaria.

Primaguine is contraindicated in any trimester of pregnancy and lactation upto 6 months. Radical cure can be done by primaguine during postpartum period preferably after 6 month if mother is nursing with breast feeding.