Title: Women with Epilepsy: Comparison between Monotherapy and Polytherapy in Pregnancy
Authors: Dr Prameeda PR, Dr Shahida J, Dr Mayadevi Brahmanandan, Dr Seetha PM
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.135
Abstract
Background: Incidence of seizure disorder in women attending antenatal clinics is estimated to be 0.3-0.5% of all births. These pregnancies are a challenge to patient and clinician alike, the double burden of seizures and the antiepileptic drugs [AED] exposure are responsible for the poorer outcome of infants born to mothers with epilepsy.
Aim of Study: To describe the obstetric and perinatal outcome of women with epilepsy with respect to those on monotherapy and polytherapy of antiepileptic drugs
Materials and Methods: This was a descriptive study conducted in the antenatal outpatient clinic, antenatal wards and labour room of a tertiary care hospital over a period of one year. All pregnant women with pre-existing or recently diagnosed epilepsy after 20 completed weeks of gestation, a total of 126 patients were recruited. All patient details were collected using a structured questionnaire after getting their consent. Data were analysed using SPSS version 17.0 to obtain Chi square test and p value. The significance of the findings were interpreted.
Results: 126 pregnant women with epilepsy diagnosed before or during pregnancy were studied. Of these, 87 were taking anti-epileptic medications. 59.5% were on monotherapy and 9.5% on polytherapy AED. Childhood onset was most common [56.3%] followed by adolescent age of onset. (30.2%) 13% had adult onset epilepsy. 7% women who were not on AED had to be started on AED {mono plus poly]. 19.8% women had to increase their AED dose during pregnancy. 66.6% had no change. All the maternal antenatal complications studied in the monotherapy/polytherapy groups were comparable
Conclusions: Careful planning and management of any pregnancy in WWE is essential to increase the likelihood of a healthy outcome for mother and infant.
Keywords: women with epilepsy (WWE), anti-epileptic drugs.
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