Affiliation:
1. Universidade de São Paulo (USP)
2. Universidade Estadual de Ciências da Saúde Alagoas (UNCISAL)
3. Universidade Municipal de São Caetano do Sul (USCS)
4. Universidade São Judas Tadeu (USJT)
Abstract
Abstract
Objectives
To describe obstetric and neonatal outcomes, antiseizure medication (ASM) use, and types of seizures in pregnant women with epilepsy (PWWE).
Methods
This retrospective cohort study used data collected from the medical records of high-risk maternity hospitals in Alagoas. PWWE aged < 40 years, with controlled or refractory seizures and pregnant women without epilepsy (control group) between 2008 and 2021 were included in the study.
Results
The obstetric and neonatal outcomes observed in PWWE were pregnancy-related hypertension (PrH), vaginal bleeding, preeclampsia, oligohydramnyos, polyhydramnios, stillbirth, greater likelihood of PrH in those with generalized tonic-clonic seizures (GTCS), maternal ICU admission in those with GTCS and status epilepticus and phenytoin and lamotrigine use. PWWE with GTCS had a higher risk of stillbirth. and premature delivery. PWWE with status epilepticus were treated with lamotrigine. Phenobarbital(PB) with diazepam was commonly used in GTCS and status epilepticus. 14% of the patients did not use antiseizure medication (ASM), 50.2% used monotherapy, and 35.8% used polytherapy. 60.9% of patients used PB and 25.2% used carbamazepine.
Conclusion
This study describes the association between adverse obstetric and neonatal outcomes and severe seizure types in PWWE.
Publisher
Research Square Platform LLC
Reference29 articles.
1. Operational classification of seizure types by the International League Against Epilepsy. Epileptic seizures and epilepsy: definitions proposed by the international league against epilepsy (ILAE) and th international bureau for epilepsy (IBE);Fisher RS;Epilepsia. 2017Apr
2. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classifi cation and Terminology, 2005–2009;Berg AT;Epilepsia.,2010
3. Moshé SL, Perucca E, Ryvlin P, Tomson T. Epilepsy: new advances. Lancet. 2015 Mar 7;385(9971):884 – 98. doi: 10.1016/S0140-6736(14)60456-6. Epub 2014 Sep 24. PMID: 25260236.
4. Tomson T, Battino D, Bromley R, Kochen S, Meador K, Pennell P, Thomas SV. Manejo da epilepsia na gravidez: um relatório da Força-Tarefa da Liga Internacional Contra a Epilepsia sobre Mulheres e Gravidez. Disord epiléptico. 2019 Dec 1;21(6):497–517. doi: 10.1684/epd.2019.1105. 31782407.
5. Complications during pregnancy in women with epilepsy: a population-based cohort study;Borthen I;THE BJOG.,2009