Management of Epilepsy and Pregnancy

Thomas, Sanjeev V

doi:10.1002/9781118531037.ch17

Cited by 20 publications

(15 citation statements)

References 44 publications

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“…[7] Literatür incelendiğinde, epilepsi tanılı gebelerin üçte birinde, gebelik sırasında nöbet sıklığında artma olduğu rapor edilmiştir. [9] Parsiyel epilepsisi olan veya çoklu AEİ tedavisi uygulanan hastalarda, gebelik sırasında nöbet geçirme riskinin oldukça yüksek olduğu bildirilmiştir. Bununla birlikte, epilepsi hastası olan gebelerin yaklaşık yarısının bu dönemde nöbet geçirmedikleri görülebilmektedir.…”

Section: Discussionunclassified

Prevalence of Seizures in Pregnant Women with Epilepsy and Pregnancy Outcomes

Pak¹,

Bozdemir²,

Aslan³

et al. 2018

Epilepsi

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Objectives: Management of pregnant patients with epilepsy is difficult. Despite the high healthy birth rate (92-96%); prematurity, fetal or neonatal death, congenital malformations and developmental failure rates are higher than the average population. The seizure rates of the majority of the patients with epilepsy do not change during pregnancy. The purpose of this study is to determine the frequency of epileptic seizures of the patients during pregnancy and rate of malformations that may be encountered in newborn babies.Methods: 55 pregnant patients with epilepsy who were born between February 2014 and February 2016 were included in the study. Types of seizures, frequency, anti-epileptic drugs used, measures of infants, malformations in infants were recorded. Results: During pregnancy; it was determined that the frequency of seizure was 56.4% (n=31), and 21.8% of patients (n=12) had increased seizure frequency whereas 21.8% (n=12) had lower seizure frequency. 3.6% of infants were lost in intrauterine. 7.3% of infants had a malformation.Conclusion: Only 21.8% of the pregnant women had an increase in seizure frequency. Malformation and mortality rates were higher in infants of patients with generalised seizures. It was observed that patients who used monotherapy gave birth to more healthy babies than those using polytherapy.Amaç: Epilepsi tanılı gebe hastaların yönetimi zordur. Yüksek oranda sağlıklı (%92-96) çocuk doğurmalarına rağmen, prematüre doğum, fetal ve neonatal ölüm riski, konjenital malformasyonlar ve gelişme geriliği oranları normal populasyona göre artış göstermektedir. Epilepsi tanılı kadın hastaların büyük kısmında gebelik döneminde nöbet sıklıkları değişmemektedir. Bu çalışmada amaç epilepsi tanılı gebelerin, gebelik dönemindeki nöbet sıklıkları ve bu nöbetlerin yenidoğan bebeğin gelişim parametrelerine etkisinin ve yenidoğan bebekte karşılaşılabilecek malformasyonların belirlenmesidir. Gereç ve Yöntem:On dört Şubat 2014-14 Şubat 2016 tarihleri arasında doğumu gerçekleşen 55 epilepsi tanılı gebe hasta çalışmaya alındı. Nöbet tipi, sıklıkları, kullandıkları anti epileptik ilaçlar, bebeklerin ölçüleri, bebeklerdeki malformasyonlar kaydedildi. Bulgular: Gebelik süresince; hastaların %56,4 (n=31)'ünün nöbet sıklığının değişmediği, %21.8'inin (n=12) nöbet sıklığının arttığı, %21.8'inin (n=12) nöbet sıklığının azaldığı belirlendi. Bebeklerden %3.6'sı intrauterin eksitus oldu. Bebeklerin %7.3'ünde malformasyon saptandı.Sonuç: Gebelerin sadece %21.8'inde nöbet sıklığının arttığı saptanmıştır. Jeneralize nöbeti olan hastaların bebeklerinde malformasyon ve mortalite oranı daha yüksek bulundu. Monoterapi kullanan hastaların, politerapi kullananlara göre daha yüksek oranda sağlıklı bebek doğurdukları gözlendi.

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Section: Discussionunclassified

Prevalence of Seizures in Pregnant Women with Epilepsy and Pregnancy Outcomes

Pak¹,

Bozdemir²,

Aslan³

et al. 2018

Epilepsi

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“…7 Data from Kerala registry of epilepsy and pregnancy indicate WWE have not increased the risk complication of pregnancy or caesarian section. 8…”

Section: Effects Of Epilepsy On Pregnancymentioning

confidence: 99%

Risks and management of pregnancy in women with epilepsy: a review

Mahajan

2018

Int J Reprod Contracept Obstet Gynecol

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Women with epilepsy (WWE) face certain challenges during their pregnancy. In the present article an effort has been made to review the information regarding the frequency of seizure in pregnancy, effects of epileptic seizure on fetus, complications during pregnancy and delivery, incidences of fetal congenital malformations and infant development. The article reviews these concerns with special emphasis on management of pregnancy. Recommendations concerning prenatal counselling, anti-epileptic drug management, breast feeding and contraception are also taken up in the later part of the article.

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“…Tanımlanan olağan dışı durumlar haricinde normal doğum eylemi önerilmelidir. [5,6] Preeklamsi veya eklemsiye bağlı görülen nöbetler magnezyum sülfat ile tedavi edilirler. Doğum sırasında eklamsi ya da epilepsiye bağlı nöbetler görülebilir.…”

Section: Epilesi Hastası Gebenin Doğumuunclassified

The follow up of epileptic patients in birth and postpartum period

Bozdemir¹

2018

Epilepsi

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Women diagnosed with epilepsy must be followed by a neurologist as well as an obstetrician in the pre-pregnancy, pregnancy, birth, and puerperal periods. There are no indications for cesarean section or induced birth in epileptic patients, with the exception of some special cases, but in daily practice, cesarean section is routinely performed and these cases are referred to tertiary epilepsy centers. Likewise, withdrawal or unnecessary dose adjustment of antiepileptic drugs in breastfeeding mothers can cause adverse effects in the infant and the mother. The aim of this article is to minimize misjudgments that affect the quality of life of patients by increasing awareness of the genuine needs of pregnant women diagnosed with epilepsy during the birth and postpartum periods.

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Management of Epilepsy and Pregnancy

Cited by 20 publications

References 44 publications

Prevalence of Seizures in Pregnant Women with Epilepsy and Pregnancy Outcomes

Prevalence of Seizures in Pregnant Women with Epilepsy and Pregnancy Outcomes

Risks and management of pregnancy in women with epilepsy: a review

The follow up of epileptic patients in birth and postpartum period

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