Epilepsy in Pregnancy Flashcards
What do the physiological changes in pregnancy result in?
A lowered seizure threshold
Increase in the amount of fits
What is the danger with prolonged fits in pregnancy?
Increases the risk of fetal hypoxia
What can the maternal use of anti-epileptic drugs increase?
The risk of congenital abnormalities such as neural tube defects.
What medication can be used to decrease the risk of neural tube defects?
Folic acid 5mg per day before conception until the end of the first trimester
What is the problem with sodium valporate in pregnancy?
Associated with neural tube defects
When can a woman consider stopping all anti-epileptic medication during pregnancy?
If they haven’t had a seizure in the last 2 years
What is the safest anti-epileptic medicaton in pregnancy?
Carbamazepine
and lamotrigine
What is phenytoin associated with?
Cleft palate
How long should a woman take folic acid in order to reduce the risk of neural tube defects?
From pre-conception until the end of the first trimester (12 weeks)
How might the dose of lamotrigene need to be changed in pregnancy?
The dose of lamotrigene may need to be increased in pregnancy
If a woman if taking phenytoin, what should she be given in the last month of pregnancy?
Vitamin K- to prevent clotting disorders in newborn
How can epileptic siezures during labour be managed?
Benzodiazepine
(avoid maternal and fetal hypoxia)
Are antiepileptics safe to take whilst breast feeding?
Yes
What are the 2 main neural tube defects?
Spina bifida
Anencephaly
What type of medical management is aimed for in epilepsy?
Monotherapy
