Anti-Malarials in 1st trimester - any experience?

[Travel123]

Hello,

I'm in a bit of a dilemma and wondered if anyone had any experiences or advice to offer?

I just found out I am four weeks pregnant, and am due to travel on a work trip to a dense forest region of West Africa, a high malaria zone, on Sunday. It is rainy season there.

The doctor is a bit hopeless, in that she says she can't really recommend any anti-malarials but cannot advise me to cancel the trip. She says it's my decision.

My last (first) pregnancy ended in MC at 12 weeks and I am very paranoid about the same thing happening, although the doctor said to be aware that most pregnancies end in MC, therefore not to worry (!!).

I just wondered if anyone had taken anti-malarials during pregnancy and if so, which ones, and were they ok?

Any comments useful at this point!

Best wishes.

I think for me it would depend on what my work there would actually involved and where I was staying. If I was in a tent in the middle of forest then I'd feel differently that if it were a 4* hotel that I would rarely leave, I'd not worry about taking anti malaria. Is it too late to start taking them now anyway for protection whilst there?

Saying that though I think if it is work I would probably cancel the trip, I'd feel differently for a holiday though. But I am sure your doctor is right and everything would be fine

Thanks Bejeena! Yes it's work, and we are right out in the forest, not very good accommodation etc... Thank you!

Hmmm since it is work I would cancel the trip to be honest in your position, also in a couple of weeks you could be feeling very sick and the trip back might be a nightmare (I was in Australia when I discovered I was 6 weeks pregnant and flight home @ 8 weeks was awful).

Or have you tried another doctor for a second opinion? A private consulation (I am assuming you can confide in your work and they cover these costs?)

I had heard about birth-defects being associated with anti-malarials but wasn't sure. When I Googled I found this article, which might help you?

Reuters article

The Hospital for Tropical Diseases used to have a travel clinic (I say used to because I had heard it was closing so not sure if it is still there). The might be able to advise on a specialist issue like this?

If it was me I would cancel the trip. Antimalarials are not safe in pregnancy and pregnant women are at increased risk of complications of malaria. Completely not worth it IMO.

Really useful advice - thanks!!!

Personally I wouldn't go. There's not enough evidence to take the medication in the first trimester, and with your sad loss before I just wouldn't take the risk. Especially as it sounds you'll be in the wild. Obviously it depends on your work but I don't think they could make you go, have they done a risk assessment for you yet? If not, get them on the case straight away. Travelling in the first trimester is pretty horrible anyway, with DD I had a holiday planned when I was 8 weeks and spent the whole time feeling ill and exhausted.

Bit at that doctor though. Most pg end in a MC? What? Have I misunderstood? I don't think that's the case at all. Hope things are kinder on you this time x

I was due to travel to a high malarial area when 6 weeks pg and my GP told me that anti-malarials are contra-indicated in pregnancy and particularly in the first trimester. There is a reason that they won't prescribe them for you.

Although that particular trip was cancelled I did travel to another risk area at 14 weeks and made do with lots of insect repellent and long sleeves etc in the evenings (thankfully it wasn't high season and I didn't actually get a single bite). I seem to recall that you shouldn't use products containing deet because that can lead to birth defects but there are lots of anti-mosquito products out there which are safe in pregnancy. It's a case of weighing up the risks. I wouldn't personally risk it for a work trip.

Thanks Snowflakepie - yes I am inclined to agree. Just doesn't seem worth it. Only thing is, I cancelled a trip to Ghana last time for same reason and then MCed - worried work will just think I am such a loser!

And yes the doc really wasn't very positive, almost saying it is inevitable that I WILL have an MC. Very strange and feeling quite wobbly about everything! It is a real nightmare...

Thank you for your kind wishes, fingers crossed it will be ok this time x

Thank you mycatlikestwiglets.... I agree - I am just so worried about cancelling and then MCing and then work thinking I am just this kind of pregnancy loser who doesn't do her work cos of all her missed pregnancies. Almost funny!! I am going to try to discuss with my very nice boss this afternoon...

x