Foetal outcome and frequency of seizure occurrence in epilepsy complicating pregnancy: a cross-sectional study from Madurai, India
Article Sidebar
Main Article Content
Abstract
Background
Epilepsy during pregnancy is a complicated situation for the mother and the baby. It is also a major therapeutic challenge because most of the drugs treating epilepsy have adverse effects on the growing foetus. The main aim of the study was to evaluate the effect of epilepsy on pregnancy, the fetal outcome and frequency of seizure occurrence among pregnant women.
Methods
Epileptic patients admitted in department of Obstetrics and Gynecology (OBG), GRH, Madurai, Tamilnadu, was considered. Detailed obstetric history was recorded. History of seizures (age of onset, type, disease free interval, and history of status epilepticus) were also obtained.
Results
Majority of the epileptic mothers newborns birth weight was between 2.5 -3 kg. followed by 2.49 kg, >3 kg and <2 kg. 94.6% of the babies had good 1 min Apgar score and 93.2% of the babies had good 5 min Apgar score. Increase in frequency of seizures occurrence were observed in 16(21.3%) of cases.
Conclusion
Fetal outcome was relatively good among pregnant epileptic mothers in majority of the cases. Special importance should be given disease free interval and frequency of seizures. Regular intake of antiepileptic drug and more frequent antenatal visits should be continued.
Article Details
References
Zahn CA, Morrell MJ, Collins SD, Labiner DM, Yerby MS. Management issues for women with epilepsy: a review of the literature. Neurology. 1998;51:949-56.
Rémillard G, Dansky L, Andermann E, Andermann F. Seizure frequency during pregnancy and the puerperium. In: Janz D, Dam M, Richens A, Bossi L, Helge H, Schmidt D. Eds. . Epilepsy, Pregnancy and the Child, New York, NY: Raven Press; 1982:15–26.
Aull-Watschinger S. Fert Mitât und Schwangerschaft. In: Baumgartner, C, ed, . Handbuch der Epilepsien. Vienna, Austria; New York, NY: Springer; 2001:971-7.
Bassi V, Yerby MS, Devinsky O. Epilepsy. In: Hainline B, Devinsky O, eds. . Neurological Complications of Pregnancy, 2nd ed. Philadelphia, Pa: Lippincott Williams & Williams; 2002:185–212.
EURAP Study Group. Seizure control and treatment in pregnancy: observations from the EURAP epilepsy pregnancy registry. Neurology. 2006; 66(3):354-60.
Bauer J. Epilepsie, Schwangerschaft und Sexualitât. Darmstadt, Germany: Steinkopff; 2005.
Kamyar M, Varner M.Epilepsy in pregnancy. Clin Obstet Gynecol. 2013;56(2):330-41.
Yerby MS, Friel PN, mccormick K. Antiepileptic drug disposition during pregnancy Neurology. 1992; 42(4 Suppl 5):12-6.
Nulman I, Laslo D, Koren G. Treatment of epilepsy in pregnancy. Drugs. 1999 Apr;57(4):535-44.
Morrell MJ, Giudice L, Flynn KL, Seale CG, Paulson AJ, Doñe S, et al. Predictors of ovulatory failure in women with epilepsy. Ann Neurol. 2002;52:704–11.
Fairgrieve SD, Jackson M, Jonas P, Walshaw D, White K, Montgomery TL, Burn J, Lynch SA. Population based, prospective study of the care of women with epilepsy in pregnancy. BMJ. 2000 Sep 16; 321(7262):674-5.
Bjerkedal T, Bahna SL. The course and outcome of pregnancy in women with epilepsy. . Acta Obstet Gynecol Scand. 1973;52:245–8.
Nelson KB, Ellenberg JH. Maternal seizure disorder, outcome of pregnancy, and neurologic abnormalities in the children. . Neurology. 1982;32:1247-54.
Yerby M, Koepsell T, Daling J. Pregnancy complications and outcomes in a cohort of women with epilepsy. . Epilepsia. 1985;26:631–5.
Thomas. SV. Managing epilepsy in pregnancy - Neurol India. 2011; 59:59-65.
Chattopadhyay N, Amitava M , Shyamapada P , Mukhopadhyay P, Dipankar G, Gautam G. Foeto-maternal outcome in pregnancy with epilepsy in a tertiary care hospital J Obstet Gynecol India. 2008;58(5):406-9.
Goel P, Devi L, Saha PK, Takkar N, Huria A, Dua D : Maternal And Perinatal Outcome In Pregnancy With Epilepsy. The Internet Journal of Gynecology and Obstetrics. 2006;5(2).
Thomas SV, Indrani L, Devi GC, Jacob S, Beegum J, Jacob P, Kesavadas K, Radhakrishnan K, Sarma PS- Pregnancy in women with epilepsy: preliminary results of Kerala registry of epilepsy and pregnancy. Neurol India. 2001;49(1):60-66.
Iheanacho I, editor. Drug and Therapeutics Bulletin. Vol. 43. 2005. Anti-epileptics, pregnancy and the child; pp. 13–16.
Bardy AH. Incidence of seizures during pregnancy, labor and puerperium in epileptic women: a prospective study. Acta Neurol Scand. 1987;75(5):356-60.
Schmidt D, Canger R, Avanzini G, Battino D, Cusi C, Beck-Mannagetta G et al.Change of seizure frequency in pregnant epileptic women. J Neurol Neurosurg Psychiatry. 1983;46(8):751-5.