any experiences of taking anti-malarials while pregnant?

[hodge1]

I have to travel to Africa next month for 1 week. I will be in my second trimester by then and I have been researching the pros and cons of the anti-malarials I can take. My GP has basically left the research and decision completely up to me so I was wondering what other people may have decided to do. I think i have 2 choices:

1. take anti-malarials and accept the risks/lack of knowledge on side effects but know that they offer a more complete protection.

1. don't take anti-malarials and have a paranoid approach to wearing long sleeves and mossie rep but accept that if I do get bitten it could be bad news!

Any advice/thoughts on what i think is a shit choice to have to make??

Should add that I will be moving to live in Africa before the baby is born so this decision doesn't just effect my week-long trip.

Thanks for any help

can't help I'm afriad but for some reason I'm sure I've read somewhere there are some mossie reps that we shouldn't use due to something in it (sorry can't be more specific than that!). Might be worth checking as if you can't use mossie rep then that might limit your choice to having to take anti-materials.

thanks, DEET is in mossie rep and I have read that i shouldn't use products containing over 50% as they think it could harm the baby. Basically i am between a rock and a hard place and worried that my baby could be harmed either way.

Whereabouts are you going to?

The 'safest' antimalarial in pregnancy is chloroquine and proguanil, but many areas in Africa have chloroquine-resistant malaria.

Hi hodge. I had a similar choice to make when pg with DS. I actually found out I was pg with him on the day I was due to go to Ethiopia for a three week long work trip.

GP was next to useless as they have to advise you to take it as you are their patient, not the baby, and the risks of malaria are higher if you are pg (because your immune system isn't as good).

I was in bits - just didn't know what to do. In the end I spoke to the pharmacist and he was lovely and said if I was his daughter he wouldn't want me taking it as the effects on the baby aren't known.

I decided not to take the anti-malarials and instead to wear long socks, long sleeves, long trousers, shoes, not go out and dawn and dusk and use a mossie net - also used 50% deet mossie repellent. Whereabouts in Africa are you going? If you are 1500m above sea level there is less risk of being bitten.

Hope that helps and sorry you have to make this choice.

Hi Sidge I am off to DR Congo so unfortunately chloroquine won't work.

Thanks Bicnod funnily enough my GP seemed to be advising me against anti-malarials if anything, although to be honest i was amazed at the way in which she expected me to do all the research and basically make the decision myself, when I would of thought she would have better access to and understanding of the information surrounding anti-malarials.

Unfortunately I will be below 1500m, but after your pharmacist's advice I am leaning more towards not taking the anti-malarials. I feel there is just too little info about the side-effects on the baby. What is more the preventative measures you mentioned are just as important if you are taking the anti-malarials.

Thanks for the advice and ideas.

I had a similar choice although I was in my first trimester, which is apparently a worse time due to the baby's formation... and also had to do the research all myself, which I couldn't quite believe, their only advice was to cancel the trip. I tried talking to a really good travel clinic but they wanted to see me in London, you could always try that.

After reading up, talking to a GP friend (who said she couldn't possibly advise not taking anything) and talking with the person organising my travel in Zambia, I decided not to take anything and be super careful. I know it isn't entirely helpful, but I figured plenty of African women do have babies and cope.

I used child insect repellant through the day (not really relevant for malaria) then much stronger stuff at night, was paranoid about tucking my socks into trousers etc. and used really strong stuff (as strong as I could find) to fumigate my room every evening, and was religious about tucking my mosquito net under me in bed. I didn't get bitten once, which has never happened on previous trips.

On speaking to a woman living there she said that malaria was really common and the treatment actually much easier than they make out in the UK, because people will recognise the signs very quickly there. On the other hand, she said the only two times she had malaria were both when she was pregnant. I think that's in part because of a weakened immune system, and second because of how your body is warmer and you produce more carbon dioxide, both of the ways the female mosquitoes find you.

I'm afraid the one thing I can't do is reassure you that it all turned out fine, as I MC'd the pregnancy. To be honest, you have to make a decision that is right for you and that you can live with... and no amount of advice can help with that. But I'm in total agreement that GPs are really not very helpful in this situation. If you are moving there though, anti-malarials won't ever be a long term option and you'll have to get used to the paranoia for protecting your new baby.

Sorry I can't give a more definitive answer, but good luck with your trip and pregnancy.

hodge I found this whilst at work, you might find it helpful:

RCOG guidelines for the prevention of malaria in pregnancy