Which of the following drugs should be avoided for treatment of malaria in pregnancy
Ans. is A Primaquine Malaria in pregnancy - Treatment a. Chloroquine is the first drug used for prophylaxis and for treatment b. Primaquine is contraindicated during pregnancy c. Mefloquine can be used for chemoprophylaxis d. If oral treatment is not possible then quinine is given intravenously II. Effect of pregnancy on malaria a. The severe form of the disease in non-immune mothers b. Severe in primigravidae as compared to multiparae c. Commonly seen in the second trimester of pregnancy d. Recrudescence of infection more in primigravidae Effect of malaria on pregnancy and fetus - Abortion, preterm labor, IUGR, IUD, LBW, Increased maternal mortality and morbidity. Ref- Malaria in pregnant women Last update: 25 May 2017 Malaria infection during pregnancy is a significant public health problem with substantial risks for the pregnant woman, her fetus, and the newborn child. Malaria-associated maternal illness and low birth weight is mostly the result of Plasmodium falciparum infection and occurs predominantly in Africa. The symptoms and complications of malaria in pregnancy vary according to malaria transmission intensity in the given geographical area, and the individual's level of acquired immunity. High-transmission settings In high-transmission settings, where levels of acquired immunity tend to be high, P. falciparum infection is usually asymptomatic in pregnancy. Yet, parasites may be present in the placenta and contribute to maternal anaemia even in the absence of documented peripheral parasitaemia. Both maternal anaemia and placental parasitaemia can lead to low birth weight, which is an important contributor to infant mortality. In high-transmission settings, the adverse effects of P. falciparum infection in pregnancy are most pronounced for women in their first pregnancy. Low-transmission settings In low-transmission settings, where women of reproductive age have relatively little-acquired immunity to malaria, malaria in pregnancy is associated with anemia, an increased risk of severe malaria, and it may lead to spontaneous abortion, stillbirth, prematurity and low birth weight. In such settings, all pregnant women, regardless of the number of times they have been pregnant, are highly vulnerable to malaria. Infections with P. vivax Infection with P. vivax, as with P. falciparum, leads to chronic anaemia and placental malaria infection, reducing the birth weight and increasing the risk of neonatal death. For women in their first pregnancy, the reduction in birth weight is approximately two-thirds of what is associated with P. falciparum, but with P. vivax the effect appears to increase with successive pregnancies. WHO recommends the following package of interventions for the prevention and treatment of malaria during pregnancy: use of long-lasting insecticidal nets (LLINs); in all areas with moderate to high malaria transmission in Africa, intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), as part of antenatal care services; prompt diagnosis and effective treatment of malaria infections. Intermittent preventive treatment in pregnancy IPTp reduces maternal malaria episodes, maternal and fetal anemia, placental parasitemia, low birth weight, and neonatal mortality. Furthermore, all pregnant women should receive iron and folic acid supplementation as a part of routine antenatal care.
Primaquine
Quinine
Chloroquine
Mefloquine