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.

1. 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.2008Sep; 81(1):1-13.
2. Byrne BM, Sayed S, Turner MJ. Is information given to pregnant women with epilepsy adequate? Epilepsia. 1997; [Suppl.3]:266.
3. Katz JM, Devinsky O. Primary generalised epilepsy: a risk factor for seizures in labour and delivery? Seizure. 2003 Jun;12(4):217-9.
4. Tauboll E, GjerstadL,HenriksenT,Husby H. Pregnancy and birth in women with epilepsy.Tidsskr Nor Laegeforen. 2003 Jun 12;123(12):1695-7.
5. Wide K, Winbladh B, Kallen B. Major malformations in infants exposed to antiepileptic drug in utero, with emphasis on carbamazepine and valproic acid: a nation-wide, population-based register study. Acta Paediatr; 93[2]:174-6.
6. Thomas SV. Epilepsy and pregnancy. Current Science.2002;82(6):720-731
7. Olafsson E, Hallgrimsson JT, Hauser WA, Ludvigsson P, Gudmundsson G. Pregnancies of women with epilepsy: a population-based study in Iceland. Epilepsia.1998;39[8]:887-92.
8. Hiilesmaa VK, Teramo k, Granstrom ML et al. Fetal head growth retardation associated with maternal antiepileptic drugs. Lancet .1981; 2:(8239); 165-7.

Dr Shahida J

Associate Professor in O&G, Government Medical College, Alappuzha, India