Dados do Trabalho

Título

Analysis of Epileptic Pregnant Women in a Specialized Center

Introdução

Epilepsy is a condition affecting about 1% of the population and is the most common neurological disorder seen in pregnant women, affecting up to 0.4% of this group. Seizures during pregnancy are related with hypertensive syndromes, premature births, and perinatal mortality. Effectively treating pregnant women with anti-seizure medications (ASMs) while avoiding teratogenicity is a concern in clinical practice.

Objetivo

To assess seizure type, prenatal ASM management and therapeutic effects on fetal development.

Método

Data from medical record of 136 participants, resulting in 147 pregnancies, was reviewed. These participants attended a specialized center of São José do Rio Preto, Brazil, from January 2011 to December 2020. Database of socioeconomic data, information from epilepsy and treatment used; obstetric morphological ultrasonography, and information from childbirth; was used.

Resultados

Participants were 15 to 46 years. Half of the participants (50.4%) were classified with unknown epileptic seizures, followed by focal seizures (33.3%) and generalized seizures (16.3%). In the beginning of pregnancy, 142 women used ASMs. In 25,8% of the cases, the patients were on polytherapy. The most used drug in the first trimester was carbamazepine (n = 62), followed by phenobarbital (n = 42) and valproic acid (n = 19). In 45 patients, the treatment was changed throughout pregnancy. Analysis of second trimester ultrasound showed significant association between generalized seizures and morphological heart variation when compared to focal seizures (p=0,028). There was no other significant statistical association with the seizure type and use of ASMs related to obstetric ultrasonography and childbirth alterations.

Conclusão

The study showed that an appropriated epilepsy treatment avoided a mother and children’s negative outcome. There was a statistical association between child’s cardiac abnormalities and mother’s generalized seizures.

Palavras-chave

epilepsy; pregnancy; anti-seizure medications