Epilepsy during pregnancy

Question 1

types of seizures during pregnancy?

Answer 1

1. eclamptic seizures: it is this until proven otherwise
2. pre-existing epilepsy
3. space occupying lesion/ brain bleed
4. pseudo seizure

Question 2

effect of epilepsy on pregnancy?

Answer 2

1. congenital malformations because they have been on anti-epileptic drugs. these include; neural tube defects, ventricular septal defect, hypospadias, cleft lip and palate

Question 3

highest risk of congenital malformations in patients with epilepsy is when they are taking … drug

Answer 3

sodium valproate
- rates of 12-15% of childhood autism

Question 4

effect of pregnancy on epilepsy?

Answer 4

1. high risk that seizures will deteriorate during pregnancy in about 33%.
2. some epilepsies will also have an increased in perinatal mental health issues

Question 5

define SUDEP ?

Answer 5

sudden explained death in epilepsy

Question 6

how common is SUDEP in pregnancy women ? what is it associated with

Answer 6

1/1000
poorer epileptic control

Question 7

advise for mothers with epilepsy ? prior to conception and early pregnancy

Answer 7

1. high dose folic acid 5mg/OD
2. lowest effective dose of the most appropriate anti-epileptic drug. will need to increase this during pregnancy
3. high risk care
4. early pregnancy scan
5. regular assess for seizures, sleep deprivation, stress, adherence to AEDs, seizure type and frequency

Question 8

intrapartum recommendations for mother with epilepsy?

Answer 8

1. epidural: ensure they get enough rest and reduce stres
2. avoid pethidine. use morphine