Malaria in Pregnancy

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Description

Pregnant women are particularly at risk of malaria due to the lowered acquired partial immunity prevailing in
pregnancy. Adverse pregnancy outcomes include spontaneous abortion, stillbirth, severe maternal anaemia and low birth weight (weight <2500g).

Treatment for uncomplicated Malaria in pregnancy (MIP)
• First-line treatment
• Artemether-Lumefantrine or Dihydroartemisinin-Piperaquine ( to be used across all trimesters).
• Second-line treatment
• Quinine should be used in all cases of failure to 1st line treatment.

Treatment
Severe Malaria in pregnancy
• Pregnant women, particularly in the second and third trimesters, are more likely to develop severe malaria
than other adults. Parenteral antimalarials should be given to pregnant women with severe malaria in full
doses without delay and must be started with:
• Quinine in the first trimester and Injectable artesunate in the second and third trimesters.
Intermittent Presumptive treatment (IPT)
• Sulphadoxine-Pyrimethamine (SP) is the medicine of choice for IPT;
• One adult treatment dose of 3 tablets should be given monthly (at least 4 weeks apart) during the second trimester from 13-weeks gestation onwards;
• The total number of doses recommended for the entire duration of pregnancy is up to 6 doses, under direct observation (DOT) when possible.