AAN 2009: New Guidelines Released on Pregnancy with Epilepsy

Epilepsia la gravide

Results: For WWE taking antiepileptic drugs, there is probably no substantially increased risk
(greater than two times expected) of cesarean delivery or late pregnancy bleeding, and probably
no moderately increased risk (greater than 1.5 times expected) of premature contractions or
premature labor and delivery. There is possibly a substantially increased risk of premature contractions
and premature labor and delivery during pregnancy for WWE who smoke. Seizure
freedom for at least 9 months prior to pregnancy is probably associated with a high likelihood
(84%–92%) of remaining seizure-free during pregnancy.
Recommendations: Women with epilepsy (WWE) should be counseled that seizure freedom for at
least 9 months prior to pregnancy is probably associated with a high rate (84%–92%) of remaining
seizure-free during pregnancy (Level B). However, WWE who smoke should be counseled that
they possibly have a substantially increased risk of premature contractions and premature labor
and delivery during pregnancy (Level C). Neurology®

Date din Registrulu

Studiu prospectiv , observational.Concluzii :
3607 cazuri , 96% nu au avut malf. majore.Rata de MM la politerapie a fost semnificativ mai mare 6% ca la mono. Politerapia cu VPA a fost mai mare ca risc decat fara VPA.Pt. monoterapie expunerea la CBZ a fost asociata cu cel mai mic risc. Tendinta ca LTG sa fie asociat cu mai putine MM ca VPA , dar diferenta a fost anulata de dozele mai mari de 200mg LTG/zi. Rata de MM la fem cu epi dar fara trat MAE a fost de 3.5%.Pt. VPA rata de 6.2 fata de CBZ 2.2.
Pt. LTG rata de MM a fost de 5.4 la doze .>200mg/zi.Aceasta rata a fost similara cu a celor care au primit doze < sau egale cu 1000mg VPA