Gredilla E, Pérez Ferrer A, Fornet I, Martínez Serrano B, López López M A, Gilsanz F
Servicio de Anestesiología y Reanimación, Hospital Universitario Maternal La Paz, Madrid.
Rev Esp Anestesiol Reanim. 2004 May;51(5):281-3.
We report the cases of 2 women with epilepsy who suffered generalized postpartum seizures on the first day after giving birth. The first had a history of febrile convulsions in childhood and had a seizure in the 36th week of gestation due to sleep deprivation. She had received epidural analgesia for labor pain. The second patient had had her most recent crisis at the beginning of the third trimester of pregnancy. Both patients had low serum levels of antiepileptic drugs. The pharmacokinetics of antiepileptic drugs can change during pregnancy, making seizures more difficult to control. Serum levels of these drugs should therefore be monitored more often, given that a generalized maternal seizure can have devastating consequences for the fetus. More careful planning and management of pregnancy is necessary for epileptic patients to ensure successful outcomes for both mother and fetus.
我们报告了2例癫痫女性患者的病例,她们在产后第一天发生了全身性惊厥。第一位患者童年时有高热惊厥史,在妊娠36周时因睡眠不足而发作。她分娩时接受了硬膜外镇痛。第二位患者在妊娠晚期开始时出现了最近一次发作。两名患者的抗癫痫药物血清水平均较低。抗癫痫药物的药代动力学在怀孕期间可能会发生变化,使癫痫发作更难控制。因此,鉴于母亲全身性惊厥可能对胎儿造成毁灭性后果,应更频繁地监测这些药物的血清水平。癫痫患者需要更精心的妊娠规划和管理,以确保母婴均取得成功结局。