Fertility rate of epileptic women at Kenyatta National Hospital

J, Kariuki; Joshi,; Adam, Andi Muhammad; Kwasa, Too; Machoki, M'Imunya

doi:10.4314/eamj.v85i7.9646

Cited by 10 publications

(16 citation statements)

References 7 publications

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“…Seventeen articles were retained after screening the search results; these included 16 research articles [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and one review paper [34]. One additional study was found via manual search [35].…”

Section: Resultsmentioning

confidence: 99%

“…In Kenya, WWE were found to have reduced rates of reproductive fitness compared to the general population [26]. Notwithstanding, the characteristics of the menstrual cycle of WWE (age at menarche, length of cycle, and duration of flow) were within normal limits [26].…”

Section: Quality Of Life Sexuality and Marriage Among Wwementioning

confidence: 98%

“…The Senegalese study found that 75% of WWE were sexually active, of which four out of five experienced reduced sexual drive which was attributed to AED (phenobarbital, carbamazepine and valproate) [18]. In Kenya, WWE were found to have reduced rates of reproductive fitness compared to the general population [26]. Notwithstanding, the characteristics of the menstrual cycle of WWE (age at menarche, length of cycle, and duration of flow) were within normal limits [26].…”

Section: Quality Of Life Sexuality and Marriage Among Wwementioning

confidence: 99%

“…Two studies examined contraceptive use among WWE in SSA [18,26]. In a Senegalese cohort, 62/120 (51.2%) WWE reported using contraception, with about one third of them (24/62) resorting to oral contraceptives [18].…”

Section: Pre-conception Period and Family Planningmentioning

confidence: 99%

“…epileptic treatment, including-enzyme inducing AEDs; two of them (4.8%) still conceived despite proper contraception [18]. In Kenya, only 14.7% of WWE of reproductive age (15-49 years) were using any form of contraception and for a median duration of 5.5 years (range 1-10 years) [26]. Findings from AED-treated WWE in Uganda showed that the menstruation periods were significantly associated with breakthrough seizures [33], while 7/23 (30.4%) WWE in Nigeria identified menstruation as a seizure trigger [19].…”

Section: Indicationmentioning

confidence: 99%

See 4 more Smart Citations

Women with epilepsy in sub–Saharan Africa: A review of the reproductive health challenges and perspectives for management

Menon

Fodjo

Weckhuysen

et al. 2019

Seizure

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Background: Epilepsy is one of the commonest neurological conditions affecting women of reproductive age. Epilepsy management during pregnancy is a clinical conundrum, requiring a balance between seizure control and risk minimization for the women with epilepsy (WWE) as well as for their fetuses. The objective of this comprehensive review is to explore the reproductive health challenges of WWE in sub-Saharan Africa (SSA) and ways to address them. Method: Relevant documentation published until June 2019 were retrieved via literature searches performed in PubMed and Google Scholar, as well as a manual search to identify grey literature. Results: WWE in SSA are generally more stigmatized and sexually exploited than women without epilepsy. Contraception use among WWE was reported only in Senegal (51%) and Kenya (14.7%). Only two prospective studies (one in Senegal and one in Nigeria) investigated pregnancy outcomes for a total of 97 WWE. The prevalence of convulsive epilepsy in pregnancy was estimated at 3.33 per 1000. Among pregnant WWE treated with first line anti-epileptic drugs, 16.2% had miscarriages, 41.9% premature births, and 4.1% had babies with malformations. Carbamazepine, which is frequently prescribed to pregnant WWE in SSA, still entails a 2.1-fold increased risk of congenital malformation. No reports were found concerning pre-conceptual counseling and post-natal outcomes in WWE in SSA. Conclusion: Our review underscores the need for contextualized evidence-based clinical guidelines and a collaborative approach to treat WWE in SSA. High risks of congenital malformations and drug interactions with first line AED warrant the provision of safer second line alternatives.

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