Malariaprophylaxe und Notfalltherapie in der Schwangerschaft – Aktuelle Datenlage und Empfehlungen

Eine Malariainfektion ist in der Schwangerschaft ein ernst zu nehmendes Risiko für Mutter und Kind, sodass schwangeren Frauen von einer Reise in Malariagebiete grundsätzlich abgeraten werden sollte. Kann eine Reise nicht verschoben werden, so ist ein konsequenter Expositionsschutz inklusive der Nutzung von Repellentien und medikamentöse Malariaprophylaxe für schwangere Reisende unabdingbar.

Im Allgemeinen wird Mefloquin als Prophylaxe und Notfalltherapie in der Schwangerschaft empfohlen. Chloroquin ist aufgrund der weltweiten Resistenzen nur bedingt einsetzbar. Im Falle einer Notfalltherapie in Gebieten mit hohen Resistenzraten gegen Mefloquin kann wohl Artemether-Lumefantrin empfohlen werden. Grundsätzlich ist aber zu sagen, dass vor allem für das erste Trimenon die Datenlage für alle aktuell verfügbaren Antimalariamedikamente unzureichend ist.

Malaria infections during pregnancy pose a serious risk for mother and child, so that pregnant women are generally advised not to travel to regions where malaria is endemic. Is it not possible for a pregnant woman to cancel or postpone her travel, it is indispensable for her to use efficient prophylaxis against malaria including repellents and antimalarials. In general mefloquine is recommended as prophylaxis and stand-by therapy rather than anything else. In areas with high resistance against mefloquine, arthemeter-lumefantrine should be considered as an option. Nevertheless it should be noted, that especially for the use of antimalarials during the first three month of pregnancy data is still insufficient.

Key words

malaria - pregnancy - prophylaxis - stand-by

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