The WHO (2005) gives the following advice: "because of the risk of quinine induced hyperinsulinemia and hypogycemia, artesunate and artemether are the drugs of choice for treatment of severe malaria in the 2nd and 3rd trimester. Data on the use of artemisinin derivatives in the 1st trimester are limited. However, neither quinine nor artemisinin derivatives should be withheld in any trimester if they are considered life saving for the mother."