Epilepsy in pregnancy

Kinney, Michael; Morrow, James

doi:10.1136/bmj.i2880

Cited by 21 publications

(17 citation statements)

References 70 publications

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“…The importance of planning the pregnancy should therefore be brought up regularly in each routine consultation with women with epilepsy with childbearing potential. The standards of preconception care for women with epilepsy have been discussed and reviewed in the past (Kinney and Morrow, 2016). A protocol for preconception care is provided in table 3.…”

Section: Optimal Management Before Pregnancy Preconception Carementioning

confidence: 99%

Executive Summary: Management of epilepsy in pregnancy: A report from the International League Against Epilepsy Task Force on Women and Pregnancy

et al. 2019

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Section: Optimal Management Before Pregnancy Preconception Carementioning

confidence: 99%

Executive Summary: Management of epilepsy in pregnancy: A report from the International League Against Epilepsy Task Force on Women and Pregnancy

et al. 2019

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“…9 Ask the woman to come back if she decides to stop contraception and plan a pregnancy, as aspects of preconception care differ for women with epilepsy. 10 If a patient is planning to conceive in the foreseeable future, explain the risks of fetal malformation with different anti-epileptic drugs (table 2⇓). Valproate has the highest teratogenic risk and affects long term neurodevelopment.…”

Section: (Web Supplement)mentioning

confidence: 99%

Contraception advice for women with epilepsy

Gooneratne

Wimalaratna²,

Ranaweera

et al. 2017

BMJ

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“…Lamotrigine and levetiracetam are recommended as first‐line agents in patients who would otherwise be considered for sodium valproate therapy (women with generalised epilepsy syndromes) due to the lower rate of MCM associated with their use, and due to the lower risk of subsequent cognitive and neurodevelopmental problems . It must be noted that the levels of these drugs may fall with advancing gestation, and therefore dose titration may be required to prevent seizures effectively . Clobazam is also used for exacerbation of seizures during pregnancy or in the postnatal period, and is considered relatively safe …”

Section: Anti‐epileptic Drugs and Pregnancymentioning

confidence: 99%

“…32 It must be noted that the levels of these drugs may fall with advancing gestation, and therefore dose titration may be required to prevent seizures effectively. 33 Clobazam is also used for exacerbation of seizures during pregnancy or in the postnatal period, and is considered relatively safe. 34 Monitoring plasma levels of anti-epileptic drugs during pregnancy…”

Section: Other Obstetric Risks From Anti-epileptic Drugsmentioning

confidence: 99%

The management of pregnant women with epilepsy: a multidisciplinary collaborative approach to care

Bhatia

Adcock

Mackillop

2017

The Obstetric & Gynaecologis

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Key content Epilepsy is the most common serious neurological problem encountered in pregnancy; however, women with epilepsy are often not referred to high‐risk pregnancy services. The 2015 Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE‐UK) report on maternal mortality highlights that the care of pregnant women with epilepsy requires urgent improvement. The two most recently available guidelines (Scottish Intercollegiate Guidelines Network and Royal College of Obstetricians and Gynaecologists guidelines) require comparative critical appraisal. Collaboration between general practitioners, specialist epilepsy nurses/midwives, obstetricians, obstetric physicians, neurologists and anaesthetists is vital to ensure optimal standardised management. Learning objectives To understand the role of pre‐conception counselling: to include advice on seizure control, anti‐epileptic drugs (AEDs) and pre‐conception folic acid. To understand the risk factors associated with poor outcomes in pregnant women with epilepsy. To understand the risks associated with specific types of AEDs: mono‐ and polytherapy. To understand the issues regarding the titration of AEDs during pregnancy, postnatal and breastfeeding periods. To understand the importance of a multidisciplinary antenatal, intrapartum and postnatal schedule of care and special considerations. Ethical issues When should we advise women to avoid pregnancy? When, how and by whom should AEDs be modified? Are women with epilepsy aware of the risk of sudden unexpected death in epilepsy in pregnancy?

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Epilepsy in pregnancy

Cited by 21 publications

References 70 publications

Executive Summary: Management of epilepsy in pregnancy: A report from the International League Against Epilepsy Task Force on Women and Pregnancy

Executive Summary: Management of epilepsy in pregnancy: A report from the International League Against Epilepsy Task Force on Women and Pregnancy

Contraception advice for women with epilepsy

The management of pregnant women with epilepsy: a multidisciplinary collaborative approach to care

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