Risk and management of 15 cases of pregnancies with epilepsy / 中华围产医学杂志

ABSTRACT

Objective To study the risk of pregnant women with epilepsy and its appropriate treatment. Methods A retrospective medical records review was conducted in 15 pregnant women with epilepsy at Peking Union Medical College Hospital from 1984 to 2004. The data were collected including maternal age at delivery, parity, gestational weeks at delivery, types of epilepsy, occurrence of seizures during trimester,mode of delivery and neonatal outcome. Results The prevalence of pregnancy with epilepsy was 0.06%. Six cases(40%)were aged 20～29, and 9 (60%) aged 30～36. There were 14 primigravidas, and 1 multiparity. One case delivered before 37 weeks and 14 after 37 weeks. The onset of epilepsy occurred before the age of 20 in 66.7% of women. During pregnancy, the number of occurrence of seizures increased in 5 patients (33.3%), decreased in 1 patient(6.7%), 9 cases(60%)were the same to non-pregnant period and 7 cases(46.7%)had no seizures. Ten women(66.7%) were on mono-medication, while 4 (26.7%) cases were on combined medication and 1 (6.6%) patient without medication. The Apgar′s score of all children was 10 at delivery and no congenital malformation was found. Two cases had breast-feeding postpartum. Conclusions Women with epilepsy should have prepregnant counseling. The lowest dose of antiepileptic drug (AED) and folic acid supplementation should be recommended before anticipated conception. During trimester, the blood concentration of AED should be closely monitored in order to adjust the dose. The prenatal outcome will be improved with proper management.