Severe Malaria in Pregnancy

Treatment

In the management of severe malaria in pregnancy, special attention must be paid to anaemia, hypoglycaemia, and pulmonary oedema.

Treatment

Parenteral Artesunate is the recommended treatment for severe malaria in all pregnant women. Give artesunate 2.4 mg/kg body weight IV bolus or IM on admission (at 0 hour), repeat at 12 hours and 24 hours, then once daily, for no more than 6 days. However, once patient can take oral treatment and at least 24 hours of parenteral therapy has been administered, discontinue parenteral therapy and commence a full 3-day course of either DP or LA.

Pregnant women in all trimesters can be treated with parenteral Quinine if Parenteral Artesunate is not available or contraindicated. The dose is 20 mg/kg body weight as loading dose, followed by a maintenance dose of 10 mg/kg 12-hourly until patient is able to take oral medication and at least 24 hours of parenteral therapy has been administered.

Switch to DP or LA as soon as the patient is able to take oral medication and at least 24 hours of parenteral therapy has been administered.