Barrett Helen L, Nitert Dekker Marloes, Lust Karin, Fagermo Narelle, Wolski Penny, Callaway Leonie K
Department of Obstetric Medicine, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia; School of Medicine, The University of Queensland; UQ Centre for Clinical Research, The University of Queensland, Brisbane, Qld, Australia.
Aust N Z J Obstet Gynaecol. 2013 Dec;53(6):540-3. doi: 10.1111/ajo.12139. Epub 2013 Nov 6.
Australian Fitness to Drive guidelines suggest that anyone who has had a seizure of any kind in the context of a 'metabolic' disorder should avoid driving for a period of 6 months. The special case of eclampsia is not mentioned.
In this study, we aimed to assess what advice healthcare professionals involved in the peripartum care of women provide to women who have an eclamptic seizure, what investigations they would conduct to exclude other causes of seizures and their level of awareness of whether eclampsia was addressed in the Australian Fitness to Drive guidelines.
A survey of 165 healthcare professionals attending the 2012 Society of Obstetric Medicine of Australia and New Zealand annual scientific meeting. Participants included registered nurses, midwives, consultant obstetricians, consultant physicians, doctors in training and others, interested in medical disorders of pregnancy.
One hundred and nine conference attendees completed the survey (response rate 66.1%). 58 respondents (53.2%) had cared for 5 or more women with peripartum seizures, and 23 respondents (21.1%) had cared for 10 or more women with peripartum seizures. 46 respondents (42.2%) had never considered the issue of driving after an eclamptic seizure. For those who had considered the issue, advice ranged from no restriction (n = 5, 4.6%), no driving for 1-2 weeks (n = 14, 12.8%), no driving for 3 months (n = 20, 18.4%) or no driving for 6 months (n = 6, 5.5%).
Many healthcare professionals caring for women with peripartum seizures have not considered issues relating to fitness to drive after an eclamptic seizure. There is a wide range of advice provided. Better prospective data are required regarding the risk of subsequent seizure after eclampsia, to inform clear fitness to drive guidelines.
澳大利亚驾驶适宜性指南建议，任何在“代谢”紊乱情况下发生过任何类型癫痫发作的人应在6个月内避免驾驶。该指南未提及子痫这一特殊情况。
在本研究中，我们旨在评估参与围产期妇女护理的医疗保健专业人员会向发生子痫性癫痫发作的妇女提供何种建议，他们会进行哪些检查以排除癫痫发作的其他原因，以及他们对澳大利亚驾驶适宜性指南中是否涉及子痫的认知程度。
对参加2012年澳大利亚和新西兰产科学会年度科学会议的165名医疗保健专业人员进行了一项调查。参与者包括注册护士、助产士、产科顾问医生、内科顾问医生、实习医生以及其他对妊娠医学疾病感兴趣的人员。
109名与会者完成了调查（回复率66.1%）。58名受访者（53.2%）曾护理过5名或更多围产期癫痫发作的妇女，23名受访者（21.1%）曾护理过10名或更多围产期癫痫发作的妇女。46名受访者（42.2%）从未考虑过子痫性癫痫发作后的驾驶问题。对于那些考虑过该问题的人，建议范围从无限制（n = 5，4.6%）、1 - 2周内不得驾驶（n = 14，12.8%）、3个月内不得驾驶（n = 20，18.4%）到6个月内不得驾驶（n = 6，5.5%）。
许多护理围产期癫痫发作妇女的医疗保健专业人员尚未考虑子痫性癫痫发作后的驾驶适宜性问题。所提供的建议范围广泛。需要更好的前瞻性数据来了解子痫后再次发作的风险，以便制定明确的驾驶适宜性指南。
