Antimalarials During Pregnancy: a Review Article

Plasmodium falciparum malaria in pregnancy poses substantial risk to pregnant women and their neonates. The WHO recommended that pregnant women with demonstrable malaria illness should he treated with effective and safe antimalarial drugs. Safety to the pregnant woman and her unborn child might be hampered by the spread of mutlidrug resistant falciparum malaria and limited literature concern their usage during pregnancy. Chloroquine is generally considered safe in all trimesters of pregnancy; sulfadoxine- pyrimethamine appears safe in the second and third trimesters of pregnancy. Quinine is the drug of choice for severe malaria and has been reported to be safe even in the first trimester of pregnancy. Few reports are available concerning artemisinins usage during pregnancy although the World Health Organization recommended their usage during pregnancy. While tetracyclines and primaquine are absolutely contraindicated during pregnancy, halofantrine, amodiaquine, mefloquine are of questionable safety during pregnancy. The first trimester of pregnancy [the period of organogenesis] is the critical period: only chloroquine and quinine were reported recently to have safely profile in this period. However, due to chloroquine resistance, quinine remains the drug of choice