Pregnancy with epilepsy and antiepileptic drug therapy on fetomaternal outcome

ABSTRACT

Background: Pregnancy women with epilepsy may have higher chances of obstetric complications, aggregative seizures, major congenital malformations, and abnormal deliveries. Monotherapy or polytherapy of anti-epileptic drugs are usually associated with adverse outcomes in pregnant women with epilepsy. Aim and Objectives: The aim of the study was to evaluate the effect of epilepsy and antiepileptic drug (AED) therapy on the fetomaternal outcome in pregnant women. Material and Methods: A total of 46 pregnant women with epileptic seizures between 18 and 35 years with mean age of 26.46 years were included in the study. The demographic, clinical, and obstetrical data were collected from the medical records. The AED monotherapy and polytherapy with drug dosage details were noted. The details of mode of delivery, outcome of seizures in post-natal period and fetal outcome were gathered. Results: About 65.21% cases were under AED polytherapy and 34.78% cases were under AED monotherapy. Majority cases had carbamazepine (CBZ) and sodium valproate mono and polytherapy. Majority had normal vaginal delivery (65.11%). Single or in combination use of sodium valproate, CBZ, and phenytoin are associated with major congenital malformations (9%). Postpartum hemorrhage was observed in 6.52% cases and postpartum seizure occurrence was observed in 8.69% cases. Conclusion: A well planned pregnancy, continuous monitoring for congenital malformations and fetal growth restriction is necessary in pregnant women under AED therapy for better maternal and fetal outcome.