Malaria in pregnancy Flashcards
Prophlaxis of malaria during pregnancy
Mefloquin in 2nd and 3rd trimester
what do the blood cells do in P. falciparum infection which they don’t in vivax, ovale and malariae?
parasites sequestered in the placenta in falciparum, evading host defences such as splenic processing and filtration
issues with malaria rapid detection tests in pregnancy
Rapid detection tests may miss low parasitaemia, which is more likely in pregnant women, and rapid
detections tests are relatively insensitive in P. vivax malaria.
how to diagnose malaria
thick and thin blood films
how to rule out malaria
In a febrile patient, three negative malaria smears 12–24 hours apart rules out the diagnosis of malaria.
to treat P. vivax, P. ovale or P. malariae (i.e. non-falciparum) in pregnancy
chloroquine
Chloroquine for 3 days
Then weekly until delivery to prevent relapse
then primaquine postnatally to prevent relapse (for 3 months?)
to treat uncomplicated P. falciparum
vs
treating severe falciparum
uncomplicated =
quinine + clindamycin
or Riamet
or Malarone
severe = IV artesunate or IV quinine
side effect of quinine in late pregnancy
Quinine is associated with severe and
recurrent hypoglycaemia in late pregnancy
atovaquone-proguanil is AKA
malarone
artemetherium lumefantrinum is AKA
Riamet
what to do if you diagnose falciparium in pregnancy
admit to hospital, no matter if it’s uncomplicated or not
side effects of quinine in general
tinnitus, headache, vomiting, diarrhoea, blurred vision
is malaria notifiable in the UK
yes
mefloquine is AKA
Larium
what antimalarials must not be taken in pregnancy
Doxycycline and primaquine are not recommended during pregnancy as they may harm your unborn baby.
