Chapter 33 - Malaria, bites, and stings during pregnancy

Summary

This chapter focuses on management of mosquito bites (including malaria), ticks and Lyme disease, Hymenoptera (bees and wasps), snakebites, scorpion and jellyfish stings during pregnancy. Mefloquine is the anti-malarial agent of choice for chloroquine-resistant areas, and evidence suggests it is not associated with an increased risk to the fetus. Careful fluid management is also very important. Dehydration as well as fluid overload should be avoided, because both could be detrimental to the mother and/or the fetus. Hyposensitization therapy is useful in the treatment of allergic disease and in the prophylaxis of anaphylaxis to Hymenoptera stings. First aid for scorpion stings is generally symptomatic, including analgesia, either systemic (opiates or acetaminophen) or locally applied (such as a cold compress). More studies and human investigations are required to evaluate the risk-benefit profiles of snake and scorpion antivenoms on pregnant mothers, embryos, and fetuses.