La Epilepsia en la mujer embarazada / Epilepsy in the pregnant woman

ABSTRACT

Introduction: epilepsy is defined as the presence of recurring unprovoked crisis, and whose treatment is typically an antiepileptic drug regimen taken daily for a long time. About 1 in 200 pregnant women develop epilepsy (0.5%). Women with epilepsy have a higher risk of poor outcomes of pregnancy, although most of their children will be normal. In pregnancy, the main risks for the mother and child are the result of poor control of their epilepsy and an elevated risk of major congenital malformations after to antiepileptic treatment. Treatment should be given to control crisis during pregnancy, despite its teratogenic potential, since the effects of epilepsy crisis are much more harmful to both mother and fetus. The treatment has to be administered as monotherapy, with minimal and effective doses able to control the crisis. In addition to the antiepileptic treatment, it is essential for the pregnant woman to be treated with folic acid at prophylactic doses of 0.4 mg daily and vitamin K with dose of 20 mg daily for the last month of pregnancy in order to prevent neural tube defects and maternal and fetal bleeding. It should also be given to the newborn immediately with a dosage of 1mg IM. The objective of this study was to determine treatment regimens that can be used to control epilepsy in pregnant women, and other measures to be taken in order to minimize the risks to the mother and fetus.