Treatment of Malaria in Pregnancy

Pregnant women are particularly susceptible to the complications of malaria infections, and therefore must be treated promptly and effectively. Unfortunately, the number of antimalarial drugs that are know to be both safe and effective in pregnancy is very limited. Antimalarial recommendations commonly exclude use in pregnant women owing to concerns about fetal toxicity. In uncomplicated Plasmodium falciparum infections, the objective of treatment is to eradicate parasitaemia, and the available drugs include chloroquine, amodiaquine, sulfadoxine-pyrimethamine, quinine, chlorproguanil-dapsone, mefloquine and the artemisinin derivatives. In severe and complicated malaria the objective is to save the mother's life. The drugs of choice are quinine and the artemisinins. Studies are urgently needed to define the best therapeutic options and to develop new treatments, especially in Africa where drug resistance already compromises all strategies of control