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妊娠期癫痫的管理

The management of epilepsy in pregnancy.

作者信息

Walker S P, Permezel M, Berkovic S F

机构信息

Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Vic., Australia.

出版信息

BJOG. 2009 May;116(6):758-67. doi: 10.1111/j.1471-0528.2009.02141.x.

Abstract

While most women with epilepsy can expect a normal pregnancy outcome, epilepsy remains a significant contributor to both maternal and perinatal morbidity. Pre-pregnancy planning must address reliable contraception and optimisation of antiepileptic drug (AED) regimens to minimise teratogenic risk while maintaining seizure control. The most recent data from the AED registries regarding malformations is presented in this review, as is the limited data on the newer AEDs and studies linking neurocognitive outcomes to AED exposure. During pregnancy, important considerations include; therapeutic drug monitoring, surveillance for obstetric complications and vigilance for seizures during the intrapartum and postpartum period.

摘要

虽然大多数癫痫女性有望获得正常的妊娠结局,但癫痫仍是导致孕产妇和围产期发病的重要因素。孕前规划必须解决可靠的避孕措施以及优化抗癫痫药物(AED)治疗方案,以在维持癫痫发作控制的同时将致畸风险降至最低。本综述介绍了AED登记处有关畸形的最新数据,以及关于新型AED的有限数据和将神经认知结局与AED暴露相关联的研究。在孕期,重要的考虑因素包括:治疗药物监测、产科并发症的监测以及分娩期和产后癫痫发作的警惕性。

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