Assessment of the safety of artemisinin compounds in pregnancy
The results of two informal consultations on the safety of artemisinin compounds for the treatment of malaria in pregnancy are presented. It was concluded that there is insufficient evidence at present to warrant a change in current WHO policy recommendations on the use of artemisinin-based products for the treatment of malaria in pregnancy. Current WHO Guidelines (WHO Guidelines for Treatment of Malaria, 2006) recommend that in uncomplicated malaria, artemisinin-based combination treatment should be used in the second and third trimester, but should be used in the first trimester only if it is the only effective treatment available. In severe malaria, artemisinins are preferred over quinine in the second and third trimester because of the hypoglycaemia associated with quinine. However, in the first trimester until more evidence becomes available on the risk benefit ratio of artemisinins, both artesunate and quinine may be considered as options. In severe malaria treatment should be started without delay and whichever medicine is immediately available should be used.
World Health Organization, Geneva. 28 pp.