Epilepsy in pregnancy: an emergency care context

Abstract

Epilepsy is a heterogeneous neurological condition that manifests clinically in seizure, and diagnosis depends on seizure duration, frequency and characteristics. Seizures can lead to injury and poorly controlled epilepsy can cause sudden death. Women with epilepsy have a small but significant risk of adverse pregnancy outcomes such as antepartum and postpartum haemorrhaging, miscarriage, preterm birth or needing an induced birth or a caesarean section; two-thirds will not experience an increase in the severity or number of seizures during pregnancy. Paramedics should be aware that women with pre-eclampsia and eclampsia may have seizures, and that women may stop taking their anti-epileptic drugs or reduce dosage because of concerns over congenital malformation. Multidisciplinary care is essential for these women.