Teramo K, Hiilesmaa V, Bardy A, Saarikoski S
J Perinat Med. 1979;7(1):3-6. doi: 10.1515/jpme.1979.7.1.3.
Although maternal ingestion of antiepileptic drugs is strongly suspected of causing congenital defects, particularly oral clefts, the effect of epilepsy itself or a combined effect of drug intake and epilepsy have not been excluded as etiological factors. Very little is known about fetal oxygenation during a maternal grand mal epileptic seizure. We describe two cases in which fetal heart rate was recorded during a maternal epileptic seizure during labor. The first fetus became clearly asphyctic as judged from the fetal heart rate recording: immediately after the epileptic seizure there was a 13-minute continuous bradycardia wave with decreased short-term variability. After the bradycardia a phase of tachycardia with decreased short-term and long-term variability occurred. In the other fetus there was only a short period of bradycardia, which was followed by a phase of tachycardia and decreased short-term and long-term variability. Both fetuses were vigorous at birth 43 and 87 minutes, respectively, after the epileptic seizures of their mothers. We conclude that a maternal grand mal epileptic seizure can be ominous to the fetus. It is therefore important that epileptic seizures are controlled by optimal medication throughout pregnancy.
尽管强烈怀疑母亲摄入抗癫痫药物会导致先天性缺陷，尤其是唇腭裂，但癫痫本身的影响或药物摄入与癫痫的联合影响作为病因尚未被排除。关于母亲癫痫大发作时胎儿的氧合情况，人们知之甚少。我们描述了两例在分娩期间母亲癫痫发作时记录胎儿心率的病例。根据胎儿心率记录判断，第一个胎儿明显出现窒息：癫痫发作后立即出现持续13分钟的心动过缓波，短期变异性降低。心动过缓后出现心动过速期，短期和长期变异性均降低。另一个胎儿仅出现短暂的心动过缓期，随后是心动过速期，短期和长期变异性均降低。两个胎儿在其母亲癫痫发作后分别于43分钟和87分钟出生时均活力良好。我们得出结论，母亲癫痫大发作对胎儿可能是不祥的。因此，在整个孕期通过最佳药物控制癫痫发作非常重要。
