Background: Incidence of seizure disorder in women attending antenatal clinics is estimated to be 0.3-0.5% of all births. These pregnancies are a challenge to patient and clinician alike, the double burden of seizures and the antiepileptic drugs [AED] exposure are responsible for the poorer outcome of infants born to mothers with epilepsy. Aim of Study: To describe the obstetric and perinatal outcome of women with epilepsy with respect to those on monotherapy and polytherapy of antiepileptic drugs Materials and Methods: This was a descriptive study conducted in the antenatal outpatient clinic, antenatal wards and labour room of a tertiary care hospital over a period of one year. All pregnant women with pre-existing or recently diagnosed epilepsy after 20 completed weeks of gestation, a total of 126 patients were recruited. All patient details were collected using a structured questionnaire after getting their consent. Data were analysed using SPSS version 17.0 to obtain Chi square test and p value. The significance of the findings were interpreted. Results: 126 pregnant women with epilepsy diagnosed before or during pregnancy were studied. Of these, 87 were taking anti-epileptic medications. 59.5% were on monotherapy and 9.5% on polytherapy AED. Childhood onset was most common [56.3%] followed by adolescent age of onset. (30.2%) 13% had adult onset epilepsy. 7% women who were not on AED had to be started on AED {mono plus poly]. 19.8% women had to increase their AED dose during pregnancy. 66.6% had no change. All the maternal antenatal complications studied in the monotherapy/polytherapy groups were comparable Conclusions: Careful planning and management of any pregnancy in WWE is essential to increase the likelihood of a healthy outcome for mother and infant.
Background: Incidence of seizure disorder in women attending antenatal clinics is estimated to be 0.3-0.5% of all births. These pregnancies are a challenge to patient and clinician alike, the double burden of seizures and the antiepileptic drugs [AED] exposure are responsible for the poorer outcome of infants born to mothers with epilepsy. Materials and Methods: This was a descriptive study conducted in the antenatal outpatient clinic, antenatal wards and labour room of a tertiary care hospital over a period of one year. All pregnant women with pre-existing or recently diagnosed epilepsy after 20 completed weeks of gestation, a total of 126 patients were recruited. All patient details were collected using a structured questionnaire after getting their consent. Data were analysed using SPSS version 17.0 to obtain Chi square test and p value. The significance of the findings were interpreted. Result: 126 pregnant WWE were studied over a period of one year. Among women on AED 51.7% had seizures and 46% had statistically significant increase in frequency of seizures while women not on AED had 23% seizure and 20.6% had increased frequency of seizures during pregnancy. IUGR was statistically significant in AED group. Emergency CS 25.6% was statistically significant in AED group as compared to 10.3% among non-AED group, which could be due to higher induction rates among AED group. Conclusion: Risk of maternal and fetal complications can be reduced with effective preconceptional planning, careful management during antenatal and post partum period.
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