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12.1.7.1

Malaria in Pregnancy

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 12, Sexual and Reproductive Health.

Clinical Description

Similar presentation as in non-pregnant woman, however prone to complications:

  • Hypoglycemia, anaemia, miscarriage, fetal growth restriction, low birth weight, preterm delivery

Signs and Symptoms

  • Fever, malaise, general body pains, low appetite, headache, abdominal pain, nausea, vomiting, symptoms of anaemia. Splenomegaly.

Investigations

  • FBC / Check hemoglobin
  • Check MPs and MRDT
  • Check random blood glucose
  • Urinalysis / urine dipsticks

Pharmacological

  • In 1st trimester of pregnancy give oral Quinine 10mg/kg body weight, administered 8 hourly for 7 days OR
  • In 2ndand 3rdtrimester giveLumefantrine Artemether (LA) 12 hourly for 3 days.

Note: Pregnant women are susceptible to hypoglycemia when taking quinine.

Severe Malaria in Pregnancy

Hypoglycaedmia, reduced level of consciousness, anaemia, reduced urine output / cocacola coloured urine, convulsions

Refer to the MOH National Malaria Control Program Revised Guidelines for the Treatment of Malaria in Malawi, 5th edition, 2020, for full details of malaria management.

Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.

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