Treatment of Malaria While Pregnant

Question: What can a pregnant women affected with malaria trophozoite of p. Falciparum (++) do? Can she take chloroquine inside drip?

Answer: It depends on whether the P. falciparum in that area is chloroquine-sensitive. If yes, then chloroquine is an appropriate treatment (although it is usually given orally). However, if the P. falciparum is known to be resistant to chloroquine (as it is in many parts of the world), chloroquine would not be an appropriate treatment. 

WHO recommends that women in the first trimester of pregnancy with uncomplicated malaria receive 7 days of quinine with clindamycin. The US Centers for Disease Control and Prevention (CDC) also indicate mefloquine (usually sold under the brand name Lariam) as a treatment option in the first trimester. Women in the second and third trimesters with uncomplicated P. falciparum infection should be treated with an approved artemisinin-based combination therapy, such as artemether + lumefantrine. Women in all stages of pregnancy with severe P. falciparum malaria should initially be treated with intravenous or intramuscular artesunate for at least 24 hours, and until they can tolerate oral medication. Note this is the same treatment recommended for all adults as well as children with severe P. falciparum malaria.

Full details on recommendations for malaria treatment can be found in WHO’s “Guidelines for the treatment of malaria (3rd Edition)”.