EPILEPSY AND PREGNANCY. LITERATURE REVIEW

  • Diana Daščioraitė LSMU MA Medicinos fakultetas
  • Karolina Stankevičiūtė LSMU MA Medicinos fakultetas
  • Giedrė Jurkevičienė LSMU MA Neurologijos klinika
Keywords: epilepsy, antiepileptic drugs, contraception, pregnancy

Abstract

Epilepsy is one of the most common chronic neurological diseases. About 12.5 million women of childbearing potential have this disease. Epilepsy is not a contraindication to pregnancy and most women with epilepsy give birth to healthy children. Women of childbearing potential often face many concerns when planning a pregnancy, one of them is the use of antiepileptic drugs during pregnancy. Both in the planning of pregnancy and during pregnancy, it is necessary to strive for the most effective and safer treatment for epilepsy. Has been observed that pregnant women and the fetus may be affected by uncontrolled seizures. Therefore, there should be a balanced risk between uncontrolled epileptic seizures and the risk of antiepileptic drugs to the fetus and mother. Women with epilepsy pregnancy should be planned. They should know details and comprehensive information. In women of childbearing potential with epilepsy, proper contraceptive selection is essential. Potential drug interactions have been identified that may lead to ineffective hormonal contraceptives and reduce the effectiveness of antiepileptic drugs. Planning pregnancy it is important to consider indications and variants for the treatment of antiepileptic drugs. If possible, the antiepileptic drugs used should be changed to safer drugs. However, changes of treatment should be done before pregnancy, with sufficient provision time to evaluate the effectiveness of the new antiepileptic drugs and to determine the minimum effective dose before conception. The risk to the fetus from the use of antiepileptic drugs is associated with intrauterine development deceleration, congenital malformations, increased neurological development, cognitive functions risk of disruption. The risk can be different to the fetus from different antiepileptic drugs. The largest fetal malformations are associated with the use of Valproate, the lowest with Lamotrigine, Levetiracetam and Oxcarbazepine. To reduce this risk, the first trimester of pregnancy consumption of folic acid 4–5 mg/day is recommended. The diagnosis of epilepsy is not a contraindication to give birth by natural routes. We all know about the benefits of breastfeeding for the mother and baby. Studies show that antiepileptic drugs used had any adverse effects for breastfeeding. So all mothers with epilepsy and those taking antiepileptic drugs should be encouraged to breastfeed, except in very rare cases. 

Published
2021-02-18