The impact of seizures on pregnancy and delivery

Sveberg, Line; Svalheim, Sigrid; Taubøll, Erik

doi:10.1016/j.seizure.2015.02.020

Cited by 88 publications

(70 citation statements)

References 25 publications

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“…Although more than 90% of pregnant women do not encounter complications related to epilepsy, it has been reported that complications increase to some degree, and dismal obstetric outcome may be observed. Hence, prepregnancy counseling for epileptic women and careful management of both the pregnancy period and the delivery are of high importance [2].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcome of 149 pregnancies in women with epilepsy: Experience from a tertiary care hospital

Özdemir

Sarı

Kurt

et al. 2015

IMAS

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Abstract:Introduction: Epilepsy has a prevalence of 1.65% in adults, and every 1 in 200 pregnancies encounters its complications. We aimed to present the existing condition of and our experience with epileptic pregnant women for whom the prepregnancy counseling is inadequate in Turkey. Methods: We evaluated 149 epileptic pregnant women between March 2009 and January 2015. Demographic features of the patients, along with type and duration of epileptic seizure, time of diagnosis, date of last seizure prior to pregnancy, number and duration of seizures during pregnancy, type of AEDs, result and week of termination of pregnancy, and birth weight were registered, and also, we evaluated perinatal complications and fetal malformations. Results: Mean age of the patients was 27.12 ± 5.4 years, and mean duration from the diagnosis of epilepsy to pregnancy was 9.68 ± 5.91 years. Twenty-seven (18.12%) and 101 (67.78%) patients had polytherapy and monotherapy, respectively. We observed epileptic seizures in 103 (69.12%) patients during pregnancy, and seizures mostly occurred in the first and third trimesters. Forty-one (39.80%) patients had seizures in all three trimesters. Forty-two (28.18%) patients among all patients who had seizures during pregnancy had 5 or more seizures. Major malformations, namely, cleft lip and palate, ventriculoseptal defect, and spina bifida were observed in the patients. Mean birth week was 38.43 ± 1.68 weeks, and mean birth weight was 2965.31 ± 453.94 grams. Twenty-two patients had normal spontaneous vaginal delivery whereas 118 patients had cesarean section. Conclusions: Pregnant women with epilepsy have their own risks. These women should be followed by experienced obstetricians and neurologists during their pregnancies. Appropriate management and follow-up lead to good results almost the same as general population.

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Section: Introductionmentioning

confidence: 99%

Pregnancy outcome of 149 pregnancies in women with epilepsy: Experience from a tertiary care hospital

Özdemir

Sarı

Kurt

et al. 2015

IMAS

View full text Add to dashboard Cite

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“…The number of new cases of epilepsy per year in young women is 20–30 per 100 000 . The risk of mortality for pregnant women with epilepsy is almost ten times higher than that of the general population . The 2015 Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE‐UK) report found that epilepsy was not only the most common neurological cause of death, but was also associated with a mortality rate greater than any other single pre‐existing medical condition .…”

Section: Why Is Improved Care In Women With Epilepsy In Pregnancy Impmentioning

confidence: 99%

“…2 The risk of mortality for pregnant women with epilepsy is almost ten times higher than that of the general population. 7 The 2015 Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) report found that epilepsy was not only the most common neurological cause of death, but was also associated with a mortality rate greater than any other single pre-existing medical condition. 6 Unfortunately, the maternal mortality rate for pregnant women on AEDs is of the order of 60 per 100 000 and has not significantly improved over the last decade, despite urgent calls to improve services and care for this group.…”

Section: Introductionmentioning

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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“…However, in focal seizures where consciousness is not affected, it is generally accepted that these types of focal seizures have minimal effect on the fetus 13. However, in focal seizures where awareness and responsiveness are affected, injuries may occur.…”

Section: What Is the Effect Of Epilepsy On Pregnancy?mentioning

confidence: 99%

Update on management of epilepsy in women for the non-neurologist

Gooneratne

Wimalaratna

2016

Postgraduate Medical Journal

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Epilepsy is a common neurological disorder, prevalent in about 1% of the population. Almost half of the patients with epilepsy are women. Epilepsy and antiepileptic drugs can affect each aspect of the female human life cycle which includes menstrual cycle, contraception, fertility, conception, pregnancy and menopause. The interplay of the female hormonal state and epilepsy is complex and has to be taken in to consideration when managing their epilepsy. This review focuses on the management of women with epilepsy related to their role in reproduction.

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The impact of seizures on pregnancy and delivery

Cited by 88 publications

References 25 publications

Pregnancy outcome of 149 pregnancies in women with epilepsy: Experience from a tertiary care hospital

Pregnancy outcome of 149 pregnancies in women with epilepsy: Experience from a tertiary care hospital

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

Update on management of epilepsy in women for the non-neurologist

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