Epilepsy and Pregnancy: A Study of 153 Pregnancies in 59 Patients

Knight, A. H.; Rhind, E.G.

doi:10.1111/j.1528-1157.1975.tb04726.x

Cited by 195 publications

(98 citation statements)

References 17 publications

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“…I and II of Obstetrics and Gynecology, University of Helsinki, Finland An increased rate of malformations, particularly oral clefts, of newborn infants born to epileptic mothers has been reported in several studies [1,2,3,4,7]. Although maternal Ingestion of antiepileptic drugs is strongly suspected of causing congenital defects, the effect of epilepsy itself or a combined effect of drug intake and epilepsy have not been excluded äs etiological factors.…”

mentioning

confidence: 99%

Fetal heart rate during a maternal grand mal epileptic seizure

Teramo¹,

Hiilesmaa²,

Bardy³

et al. 1979

Journal of Perinatal Medicine

138

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An increased rate of malformations, particularly oral clefts, of newborn infants born to epileptic mothers has been reported in several studies [1,2,3,4,7]. Although maternal Ingestion of antiepileptic drugs is strongly suspected of causing congenital defects, the effect of epilepsy itself or a combined effect of drug intake and epilepsy have not been excluded äs etiological factors. Very little is known about fetal oxygenation during a maternal grand mal seizure. We describe here two cases in which fetal heart rate (FHR) was recorded during a maternal epileptic seizure during the first stageof labor. Caseno. 1.The patient was a 28-year old primipara whose own birth weight had been 1600 g. A small cleft palate was closed operatively when she was 2 years of age. She had three grand mal seizures since the age of 25. The last seizure occurred 9 months before the onset of her pregnancy. Her medication was diphenylhydantoin 100 mg daily before the pregnancy. The same dose was continued unchanged during the pregnancy. The patient attended an outpatient clinic for pregnant epileptics regularly during her pregnancy, which progressed uneventfully until term. Serial determination of 24-hour urinary excretion of estriol and human placental lactogen of the maternal serum gave normal values during the last weeks of pregnancy. FHR showed normal patterns during weekly cardiotocographic recordings during the last month of pregnancy. Labor started spontaneously at term. The membranes were ruptured and a spiral electrode was attached to the fetal scalp for recording of FHR when the cervix was 4 cm dilated 4.5 hours before delivery. 43 minutes before delivery when the cervix was 6 cm dilated the patient unexpectedly suffered a grand mal epileptic seizure, which lasted 2.5 minutes (Fig. 1) a periGyneand 10 mg intramuscularly. Fig. l shows FHR before, during and after the grand mal seizure of the mother. FHR decelerated below 120 beats/minfor over 13 minutes. The short-term variability of FHR decreased during the deceleration period, after which there was a phase of tachycaidia up to 165 beats/min with decreased shortterm and long-term variability. The mother's blood pressure was normal during the fetal bradycardia. 29 minutes after the beginning of the seizure a late deceleration bradycardia wave is seen. The fetus was delivered by cesarean section 43 minutes after the beginning of the seizure. The cesarean section was performed under general anesthesia with nitrous oxide/oxygen and succinyl choline Infusion after induction with thiobarbitone. The male infant weighed 3630 g and received an APGAR score of 8 at the age of one minute. The condition of the newborn infant was good during the following days except for slightly reduced muscular tone. The mother recovered from the Operation uneventfully. At delivery the concentration of diphenylhydantoin in maternal venous blood was only 0.9 Mg/ml. The patient assured having taken her medication regularly. The mother and the infant were discharged in good condition 9 days after the delivery.

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mentioning

confidence: 99%

Fetal heart rate during a maternal grand mal epileptic seizure

Teramo¹,

Hiilesmaa²,

Bardy³

et al. 1979

Journal of Perinatal Medicine

138

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“…[24] Nevertheless, several other studies have not demonstrated an excess risk of abortion in WWE. [14,25,26] There are conflicting reports regarding the in creased risk of nonpreteinuric hypertension, [27] pre-eclampsia, eclampsia, and abruptio placenta in WWE. Frequency of cesarean section may be increased for WWE, although most of them can have normal vaginal delivery.…”

Section: Effect Of Epilepsy On Pregnancy Infertilitymentioning

confidence: 99%

“…Seizure frequency may remain unchanged or decreases in two-third of WWE, whereas it may increase in others. [14] Seizure frequency may also vary between pregnancies in the same woman. There can be diverse patterns of seizure frequency during pregnancy.…”

Section: Effect Of Pregnancy On Epilepsymentioning

confidence: 99%

Management of Epilepsy and Pregnancy

Thomas

2013

Epilepsy in Women

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“…[2][3][4] A few studies have focused on the effect of pregnancy on epilepsy and a possible worsening of epilepsy during pregnancy, but there are studies which do not show increase in seizure frequency during pregnancy and puerperium. [5][6][7] About 2.5 million women in India suffer from epilepsy, with 52 (25%) of them being in the reproductive age group. 8 Majority of women with epilepsy will have normal, healthy infants.…”

Section: Introductionmentioning

confidence: 99%

Prospective study of fetomaternal outcome in epilepsy in pregnancy in a tertiary care hospital

Raji

Sekar

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Epilepsy is the second most common neurological disorder in obstetrics after migraine. There are conflicting reports about the effect of epilepsy on pregnancy. Objective of present study was to evaluate fetomaternal outcome in patients with epilepsy.Methods: This prospective study was conducted in Government Thanjavur medical college hospital, Tamil Nadu, India over a period of 15 months from January 2015 to March 2016 in all epilepsy cases. Total 110 epilepsy cases were admitted. In all cases maternofetal outcome were noted.Results: This study showed that the incidence of epilepsy in pregnancy in our hospital is 0.6%. 86.36% of patients were treated with antiepileptic medications during their pregnancies. Pregnancy complications were anemia, gestational diabetes mellitus, gestational hypertension, intrauterine growth retardation, premature rupture of membrane, and vaginal bleeding. Live birth rate was 91.82%. Low birth weight babies were recorded in 24 (21.82%) infants. Only one baby had congenital anomaly of cleft lip and palate.Conclusions: There was no significant increase in the risk of complications of pregnancy or delivery.Frequency of cesarean section is not increased in epileptic patients. There is no undue risk to pregnancy and childbirth in most of the cases.

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Epilepsy and Pregnancy: A Study of 153 Pregnancies in 59 Patients

Cited by 195 publications

References 17 publications

Fetal heart rate during a maternal grand mal epileptic seizure

Fetal heart rate during a maternal grand mal epileptic seizure

Management of Epilepsy and Pregnancy

Prospective study of fetomaternal outcome in epilepsy in pregnancy in a tertiary care hospital

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