Tropenmedizin. 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 Repellenzien und medikamentöser 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 v. a. für das 1. Trimenon die Datenlage für alle aktuell verfügbaren Antimalariamedikamente unzureichend ist.

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