Comparative safety of antiepileptic drugs during pregnancy

Maheshwari, Amit; Hernández–Dı́az, Sonia; Athale, Sunil; Lekhra, O. P.; Telang, Kapil; Holmes, Lewis B.

doi:10.1212/wnl.0b013e3182858ba3

Cited by 2 publications

(1 citation statement)

References 11 publications

(5 reference statements)

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“…Folic acid supplementation is a must in all cases. 8 A study by Danielsson KC observed that valproate predisposed patients to develop mild pre-eclampsia, which was not observed in patients receiving lamotrigine or levetiracetam. 9…”

Section: Antiepileptics Usagementioning

confidence: 99%

Maternal and fetal outcome of pregnancy complicated by convulsions

Fonseca

Joshi

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Convulsions in pregnancy pose serious morbidity and mortality to both mother and the fetus. Eclampsia being the most common cause. However, many medical disorders like epilepsy, cerebral malaria, meningitis, metabolic disorders etc can result in convulsions in pregnancy. This study was conducted to determine the prevalence of various aetiologies leading to convulsions and to assess how the various demographic-clinical characteristics affect the maternal as well as fetal outcome in patients with eclampsia as compared to those with convulsions other than eclampsia.Methods: This was an observational study conducted over a period of one and a half year at a tertiary institute in India. A total of 56 patients were studied in this duration. The primary objective was to determine the prevalence of the aetiologies causing convulsion as well as the maternal and fetal outcome of the pregnancy complicated by convulsions. The data regarding age, parity, mode of delivery, gestational age at birth, risk factors was obtained by a predesigned proforma.Results: A total of 56 patients were included in the study after screening 18,840 patients in the hospital. Hence the estimated prevalence of convulsions in pregnancy was 1:336 in this hospital. The most common aetiology noted was Eclampsia (69.6%) followed by epilepsy (16.1%). Others included Cerebral Malaria (3.6%), Hypocalcemia (3.6%), Neurocysticerosis (2%), Hypokalemia (1.8%) and Hypoglycemia (1.8%). Maternal case fatality rate was 3.6%. Total perinatal mortality was 14.2% of which 6 (10.7 %) were still birth.Conclusions: Eclampsia is a major cause of convulsions in pregnancy and considered to be the diagnosis unless proved otherwise. However other causes of convulsions should not be ignored. A thorough evaluation of the patient which lays a major emphasis on a detailed history taking and examination, form the crux of diagnosing the cause of convulsions and can expediate a timely and accurate treatment.

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Section: Antiepileptics Usagementioning

confidence: 99%

Maternal and fetal outcome of pregnancy complicated by convulsions

Fonseca

Joshi

2018

Int J Reprod Contracept Obstet Gynecol

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Epilepsy during pregnancy: focus on management strategies

Borgelt¹,

Hart

Bainbridge

2016

IJWH

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In the US, more than one million women with epilepsy are of childbearing age and have over 20,000 babies each year. Patients with epilepsy who become pregnant are at risk of complications, including changes in seizure frequency, maternal morbidity and mortality, and congenital anomalies due to antiepileptic drug exposure. Appropriate management of epilepsy during pregnancy may involve frequent monitoring of antiepileptic drug serum concentrations, potential preconception switching of antiepileptic medications, making dose adjustments, minimizing peak drug concentration with more frequent dosing, and avoiding potentially teratogenic medications. Ideally, preconception planning will be done to minimize risks to both the mother and fetus during pregnancy. It is important to recognize benefits and risks of current and emerging therapies, especially with revised pregnancy labeling in prescription drug product information. This review will outline risks for epilepsy during pregnancy, review various recommendations from leading organizations, and provide an evidence-based approach for managing patients with epilepsy before, during, and after pregnancy.

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Comparative safety of antiepileptic drugs during pregnancy

Cited by 2 publications

References 11 publications

Maternal and fetal outcome of pregnancy complicated by convulsions

Maternal and fetal outcome of pregnancy complicated by convulsions

Epilepsy during pregnancy: focus on management strategies

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