Epilepsy

Question 1

What are the risks to the fetus of an epileptic mother?

Answer 1

1-2% of newborns born to non-epileptic mothers have congenital defects. This rises to 3-4% if the mother takes antiepileptic medication.

Question 2

What are epilepsy treatment notes for pregnancy?

Answer 2

Aim for monotherapy
No need to monitor drug levels during pregnancy

Question 3

What are different epileptic drugs associated with?

Answer 3

sodium valproate: associated with neural tube defects

carbamazepine: often considered the least teratogenic of the older antiepileptics

phenytoin: associated with cleft palate

lamotrigine: studies to date suggest the rate of congenital malformations may be low. The dose of lamotrigine may need to be increased in pregnancy

Question 4

Is breastfeeding safe for epileptic women?

Answer 4

Breast feeding is generally considered safe for mothers taking antiepileptics with the possible exception of the barbiturates

Question 5

What should women taking phenytoin be given?

Answer 5

vitamin K in the last month of pregnancy to prevent clotting disorders in newborn

Question 6

What does HELLP stand for?

Answer 6

Hemolysis, Elevated Liver enzymes, and a Low Platelet count.

Question 7

How many patients with pre-eclampsia develop HELLP syndrome?

Answer 7

10-20% of patients with severe preeclampsia will go on to develop HELLP

Question 8

What are features of HELLP syndrome?

Answer 8

nausea & vomiting
right upper quadrant pain
lethargy

Question 9

How is HELLP syndrome treated?

Answer 9

Delivery of baby