Malaria and Pregnancy – What you need to know!

Today at VA Morning Report we had a spirited discussion with Dr. Bedimo from the ID division about malaria and patients who are pregnant. Below are some key points:

Clinical Presentation and Mechanism of Disease

  • —Estimated that 10,000 women and 200,000 infants die as a result of malaria infection during pregnancy each year
  • —Severe maternal anemia, prematurity, and low birth weight contribute to maternal and infant deaths
  • —More severe in pregnant patients with greater frequency of hypoglycemia and pulmonary compromise
  • —Prevalence greater in primagravidas patients compared to nonpregnant and multigravidas
  • —P. falciparum-parasitized erythrocytes are able to sequester within the intervillous space of the placenta (unique to falciparum compared to other malaria species like vivax)

Treatment

  • —Pregnancy itself may be considered criteria for IV therapy with falciparum malaria
  • —Drugs Safe to Use: Chloroquine, Quinine, Quinidine, Clindamycin, Mefloquine
  • —Contraindicated: tetracycline, doxycyline, primaquine
  • Atovaquone-proguanil and artemether-lumefantrine are not generally recommended during pregnancy due to lack of safety data.