title: Quinine and severe falciparum malaria in late pregnancy.
abstract: Quinine dihydrochloride was given intravenously to 12 women with severe falciparum malaria in the third trimester of pregnancy. The initial dose consisted of 10 or 20 mg salt/kg over 4 h and was followed by 10 mg salt/kg every 8 h until patients were fit to swallow, when quinine sulphate tablets were given. Uterine activity showed little or no change despite rising quinine concentrations. Of 3 patients in labour, 2 proceeded normally while a third had a successful caesarean section for fetal distress. Late (type II) decelerations of the fetal heart rate were recorded in 6 patients before treatment but in most patients signs of fetal distress diminished as the maternal temperature fell. Hypoglycaemia and hyperinsulinaemia developed in 7 patients, in 2 before quinine was started. The important toxic effect of quinine in late pregnancy is not an oxytocic action but rather its capacity to release insulin.
authors.forename: S
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: R E
authors.initials: RE
authors.lastname: Phillips
authors.forename: N J
authors.initials: NJ
authors.lastname: White
authors.forename: S
authors.initials: S
authors.lastname: Kietinun
authors.forename: J
authors.initials: J
authors.lastname: Karbwang
authors.forename: C
authors.initials: C
authors.lastname: Rackow
authors.forename: R C
authors.initials: RC
authors.lastname: Turner
authors.forename: D A
authors.initials: DA
authors.lastname: Warrell
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D007328:Insulin / Q000097:blood; D007743:Labor, Obstetric / Q000187:drug effects; D008288:Malaria / Q000097:blood / Q000188:drug therapy*; D010963:Plasmodium falciparum; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy*; D011803:Quinine / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D011803:Quinine