antimalarials when pregnant

[mummycat2011]

I came off the pill a month ago and went in to the clinic today for some travelling vaccinations as we're going away in June. The nurse recommended that we don't continue trying as pregnant women shouldn't take antimalarials. Does any one have any experience of this?

I was given the same advice. Also to wait a month or two after you've stopped taking them to let them get properly out of your system. The effect they can have on a foetus are very serious.

My experience was changing my plans so that I didn't have to take anti malarials!

Basically the nurse is right. According to my doctor, you can take Chloroquine in pregnancy but most strains of malaria are resistant because it's been around for so long. You can take Malarone or Larium in the 2nd trimester, but then you also contend with their side effects for yourself - Larium in particular I have had a horrible time on but that might be just me.

It all depends on where you are going & for how long, really. Have to work out how you feel about the various risks.

i've lived overseas for a while and not taken them before as i put a lot of effort into not getting bitten in the first place (obviously it's inevitable but odds are significantly reduced). my other half doesn't like this option though. i don't have issue with malarone or larium but i would only be three months pregnant if we are pregnant now. guess i need to get back on the pill and start trying in june :-(

I assume the trip is booked?

If not we chose to holiday in places where anti-malarials weren't necessary when I was pregnant.

yep, flights are non-refundable

Then there's not a lot of choice.

Either carry on ttc and cancel the trip (obviously you'll be hugely out of pocket) or put ttc on hold until you've been and have been back for a good few months.

Not great either way.

Where are you going?

Antimalarials (and some live vaccines) are best avoided in pregnancy. You even should avoid conceiving for 3 months after some vaccines.

Malarone can be used in pregnancy but only where essential. A holiday wouldn't really be classed as essential travel so where I work we would rather you changed the trip than prescribed you antimalarials!

Bite avoidance is essential regardless of whether you use medication or not, but cannot be relied upon as adequate antimalarial prophylaxis.

uganda

I would NOT travel to Uganda if I were pregnant.

Uganda has the one of the highest malarial transmission rates in Africa and pregnant women are particularly susceptible apparently.

They also have a very high rate of TB transmission; have you received BCG vaccine?

I think it would be safest if you must travel to use Malarone and avoid TTC for a few more months.

IIRC, anti-malarial drugs also strip the body of folic acid, so you need prescription strength (higher than normal supplement dose), or be prepared to wait 3 months or so for levels to be restored.

Malaria during pregnancy is much more serious than malaria at other times. You really do need to be very, very viligant.

i got my period today - mixed feelings about that, but decision is made. Looks like i'll be waiting a while to start trying again :-(

I would wait a while. I actually miscarried at 12 weeks a few years ago when I was in Africa due to malaria (I was very stupid ad didnt take the right dose or long enough before I went) and the larium/quinine is such potent stuff ( I was having hallucinations etc in the hospital) I would be very careful.

I aree with med - Malria is very dangerous when pregnant - I hate being reminded of my experience because I was very lucky to make it through.x

I think you have made the right decision to wait. Just to really hammer it home though, there is something else to think about:

"but i would only be three months pregnant if we are pregnant now" The first three months of pregnancy are the most crucial in terms of development and there are many many drugs which while considered safe in the 2nd and 3rd trimesters are not recommended for the first trimester for this reason.

The peace of mind you will have when you do start trying again will make the wait worth it. Hope you enjoy your trip.

yeah, thanks for the advice. we obviously did a lot of talking before deciding to start trying so to then have to wait is tough. i've made the decision now though. To be honest, i had no idea that antimalarials were so dangerous to pregnant women so it never occured to me. It's my best friends wedding so has been difficult to choose between the two. But, I can (god willing) have a baby any time; weddings only come around once.