Recommendations for the care of women with epilepsy.

Penovich, Patricia; Eck, Karen; Economou, Vasiliki V

doi:10.3949/ccjm.71.suppl_2.s49

Cited by 18 publications

(14 citation statements)

References 13 publications

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“…23,24 Oleh karena itu perlu dipaparkan langkah-langkah yang harus diperhatikan dalam menatalaksana pasien epilepsi pada kehamilan :…”

Section: Penatalaksanaan Epilepsi Pada Kehamilanunclassified

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Epilepsi dan Kehamilan

Sukiandra¹

2017

JIK

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Epilepsy is a chronic neurologic disorder that may complicate pregnancy, about 25%-33,3% epileptic seizures increasedin pregnancies. The main concern in pregnancies complicated by epilepsy includes the increased risk of congenitalabnormalities associated with antiepileptic drugs. Hormones can have major effect on seizure disorders. Women withepilepsy will have changes in seizure patterns when hormones levels shift, such as during pregnancy or right afterpregnancy. A woman with seizure disorder must be managed effectively to minimize the risk of a seizure that couldharm the fetus. Seizures can harm the developing fetus by reducing the blood supply to the placenta. Anti-convulsantmedications should not be discontinued during pregnancy. medications may be switched to those that are known to bethe safest to the developing fetus. This will reduce the risk for neural tube defects like spina bifida. Multiple drugtherapy should be avoided – if possible– and drugs should be given in divided doses to avoid high peak levels. We canprovide women with epilepsy with the available information, advise on the best treatment prior to pregnancy, andwarnings that most AEDs carry a risk above that of untreated epilepsy. Treatment should be planned in womenanticipating pregnancy

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“…23,24 Oleh karena itu perlu dipaparkan langkah-langkah yang harus diperhatikan dalam menatalaksana pasien epilepsi pada kehamilan :…”

Section: Penatalaksanaan Epilepsi Pada Kehamilanunclassified

“…Selama persalinan, OAE harus tetap diberikan, apabila perlu dapat diberi dosis tambahan dan atau obat parenteral terutama apabila terjadi partus lama 24 .…”

Section: Penatalaksanaan Epilepsi Pada Kehamilanunclassified

Epilepsi dan Kehamilan

Sukiandra¹

2017

JIK

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“…Although women with epilepsy face special challenges during pregnancy, 90% have successful pregnancies with healthy outcomes (Penovich, Eck, & Economou, 2004). Because the mainstay of treatment for epilepsy is the use of AEDs, the goal in pregnancy is to optimally control seizures using the lowest dose of a single drug if possible to reduce the teratogenic risk of AEDs to the fetus.…”

Section: Effect Of Antiepileptic Drugs On Fetus and Newbornmentioning

confidence: 99%

“…She needs to get enough sleep, eat well, exercise regularly, and take medications as prescribed for optimal seizure control. Persons with epilepsy are more likely to be diagnosed with depression (Penovich et al, 2004). Although it is important that all women of childbearing age take a daily supplement of folic acid to reduce the risk of neural tube defects in the fetus, the recommended dose range for women with epilepsy is 0.8 to 5 mg/day (Foldvary-Schaefer, 2006).…”

Section: Instructions For Self-carementioning

confidence: 99%

Meeting the Needs of the Postpartum Woman With Epilepsy

Rousseau

2008

McN: The American Journal of Maternal/Child Nursing

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Although pregnancy and postpartum are times of emotional and physical change for all women, women with epilepsy have additional concerns and face special challenges. This article describes the nursing care for this special population to help the clinical nurse provide for the safety of these women and their infants. A multidisciplinary approach is essential, and families need to be included in the care planning. Special considerations for medication management, additional rest, seizure precautions, and discharge instructions are described.

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“…DMPA has continued to be a recommended choice for women with disabilities for whom estrogen is contraindicated due to thrombotic risks, for those who have increased seizures related to their menstrual cycles, and for women who are unable to self-manage menstrual care. (Penovich, Eck, & Economou, 2004;Grover, 2002;Servais, Jacques, & Leach, et al 2002). It is a highly reliable contraceptive for women who are not able use barrier methods of contraception and may be at increased risk of sexual exploitation or abuse due to physical or cognitive limitations.…”

mentioning

confidence: 99%

Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities

Watson

Lentz

Cain

2006

Women's Health Issues

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Purpose-To evaluate any association between incidence of osteoporotic fractures and use of depot medroxyprogesterone acetate (DMPA) and/or anti-epileptic drugs (AEDs) among women and girls with developmental disabilities.Methods-Cross-sectional population-based observational study of all non-institutionalized females with developmental disabilities age thirteen and older who received fee-for-service Medicaid in Washington State during 2002 (N=6773), using administrative data.Main Findings-In a sample of 6,773 females, 140 women (2%) had an osteoporotic fracture during 2002. Among 340 users of DMPA, 13 (3.8%) had an osteoporotic fracture with an odds ratio of 2.4 (CI 95%, 1.3-4.4) for fracture compared to non-users. Among 1909 users of AEDs, 60 (3.1%) had an osteoporotic fracture with an odds ratio of 1.9 (CI 95%, 1.3-2.6) for fracture compared to non-users. We controlled for age and race (as Caucasian or non-Caucasian).Conclusions-Use of either AEDs or DMPA by women with developmental disabilities is associated with significantly increased incidence of fracture. Women and girls who have developmental disabilities may be poor candidates for DMPA use due to increased risk of fractures. Further research is indicated (1) to determine the specific risks profile of DMPA for this population, (2) to explore alternative means of managing significant menstrual problems and contraceptive needs in this population and (3) to screen current and previous users of DMPA and chronic users of AEDs for osteoporosis risk, regardless of age.Correspondence to: Kathleen C. Watson, watsonkc@u.washington.edu. Support for this study was provided by NINR NIH 5 T32 NR07106-07 and by NINR NIH P30 NR04001.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. People who have developmental disabilities (DD) are at increased risk of fractures due to cooccurrence of low BMD (Aspray et al. 1998;Jaffe, Timell, & Gulanski, 2001;Lohiya, TanFigueroa, & Iannucci, 2004) and increased incidence of falls and other trauma (Hsieh, Heller & Miller, 2001). Developmental disabilities are severe and chronic disabilities which begin before age 22 and are the result of mental retardation, cerebral palsy, epilepsy, autism or a similar condition (U.S. code Title 42, chapter 75, section 6001.5.1, 1992). They include a wide range of both physical and cognitive disabilities and many have associated health problems. NIH Public AccessDocumented risks for low BMD include limited mobility (Lohiya et al. 2004;Tyler, Snyder & Zyzanski, 2000;Jaffe, Timell, Elolia & Thatcher, 2005), use of anti-epileptic drugs (AEDs) (Ray, Papaioan...

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Recommendations for the care of women with epilepsy.

Cited by 18 publications

References 13 publications

Epilepsi dan Kehamilan

Epilepsi dan Kehamilan

Meeting the Needs of the Postpartum Woman With Epilepsy

Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities

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