Title: A Study on Maternal and Perinatal Outcome in Epilepsy Complicating Pregnancy
Authors: Prameeda PR, Shahida J, Seetha PM
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.136
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.
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.
Result: 126 pregnant WWE were studied over a period of one year. Among women on AED 51.7% had seizures and 46% had statistically significant increase in frequency of seizures while women not on AED had 23% seizure and 20.6% had increased frequency of seizures during pregnancy. IUGR was statistically significant in AED group. Emergency CS 25.6% was statistically significant in AED group as compared to 10.3% among non- AED group, which could be due to higher induction rates among AED group.
Conclusion: Risk of maternal and fetal complications can be reduced with effective preconceptional planning, careful management during antenatal and post partum period.
Keywords: WWE women with epilepsy, AED anti epileptic drugs.
References
- Meador K, Reynold MW, Crean S et al. Pregnancy outcomes in women with epilepsy: a systematic review and meta-analysis of published pregnancy registries and cohorts. Epilepsy Res. 2008 Sep;81(1):1-13.
- Byrne BM, Sayed S, Turner MJ. Is information given to pregnant women with epilepsy adequate? Epilepsia. 1997; [Suppl.3]:266.
- Thomas SV. Management of epilepsy in pregnancy.JPGM.2006;52(1)57-64.
- Richmond JR, Krishnamoorthy P, Andermann E, Benjamin A. Epilepsy and pregnancy, an obstetric perspective. Am J Obstet Gynecol. 2004 Feb; 190[2]:371-9.
- Steegers- Theunissen RP, Renier WO. Bonn GF,et al. Factors influencing the risk of abnormal pregnancy outcome in epileptic women: a multicentric prospective study. Epilepsy Res 1994;18[3]: 261-9.
- Kaneko S. Antiepileptic drug therapy and reproductive consequences: functional and morphological effects. Reprod-Toxicol 1991;5[3]:179-98.
- Jones KL, Lacro RV, Johnson KA, Adams J. Pattern of malformations in children of women treated with carbamazepine in pregnancy. N Engl. J Med.1989 Jun22;320 [25]:1661-66.