EFFECTIVENESS AND SAFETY OF CURRENT ANTICONVULSANT THERAPY DURING PREGNANCY: CASE SERIES FROM DUHOK | ||
| Duhok Medical Journal | ||
| Article 11, Volume 10, Issue 1, November 2016, Pages 11-11 | ||
| Authors | ||
| MOHAMMAD AZIZ SULAIMAN1; WALID W. AL-RAWI2 | ||
| 1Lecturer in Neurology, College of Medicine, University of Duhok, | ||
| 2Professor of Neurosurgery, College of Medicine, University of Duhok, | ||
| Abstract | ||
| Background and aim: Epilepsy is a very common chronic neurological disease that affects both male and female populations; there has been an association between epilepsy and course and outcome of pregnancy. The study aimed to study the effects of few currently used anticonvulsant drugs on pregnancy, labour, and the newborn in a small group of female patients. Methods: This retrospective, clinical case-series included women suffering from focal/complex partial/generalized epilepsy, with/without aura, before and after their marriage, who eventually became pregnant and presented to the Neurology / Neurosurgery Consultation Clinics and Private Clinics at Duhok during the period January 2005 – December 2015. The enrolled 28 women with epilepsy came from Duhok Governorate, and their ages ranged between 15 years – 40 years. A suitable format sheet has been designed in which relevant patient’s notes were recorded. All of patients had standard routine haematological and biochemical profile, including alpha fetoprotein measurement, skull Xrays, abdominal ultrasound, contrast computed tomography and magnetic resonance imaging scanning examination; all had electroencephalographic records. Patients were given anticonvulsant medication at presentation, 5mg daily folic acid supplements 2 months before and during pregnancy, plus other symptomatic drugs when appropriate; most of them were also given multivitamins and minerals preparation as additional nutritional support. The anticonvulsant drugs included Carbamazepine, Levetiracetam, Lamotrigine, and Valproic Acid, within standard dosage necessary to achieve an adequate control(seizure-free life). During the follow-up period, routine blood tests were done every 6 months to monitor the effects of those drugs on the bone marrow and the liver. Results: All have achieved good epilepsy control before, during, and after pregnancy, and during the follow-up period. Clinical examinations, blood tests, skull X-ray, computed tomography, magnetic resonance imaging were within normal; however, alpha-fetoproteins value was only abnormal in the patient who gave birth to the newborn with facio-oral defect. The course of pregnancy, labour, and post-partum period was smooth in all of the patients. All gave birth to healthy single viable newborns, having normal gestational age, birthweight or APGAR score, except one of the patients who was taking Valproic acid, her newborn had cleft lip and palate. The latter patient was switched over to carbamazepine and gave rise to a healthy newborn baby in subsequent pregnancy. Conclusions: WWE treated by CBZ, LVC, LTG and VPA showed good seizure control during pregnancy and labour whether vaginal or cesarean section. Unlike CBZ, LVC and LTG, only VPA use was associated with one case of facio-oral congenital abnormality. | ||
| Keywords | ||
| Pregnancy; women with epilepsy; safety of anticonvulsants | ||
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