Putta Swapna, Pennell Page B
Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Division of Women's Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Future Neurol. 2015 Mar;10(2):161-176. doi: 10.2217/FNL.15.4. Epub 2015 Mar 4.
Child-bearing years are often the most precarious management period in the life of a woman with epilepsy. This article reviews the results of many different studies with findings that enable the healthcare team to make confident decisions and recommendations during these critical periods. Preconceptional planning, effective contraception and folic acid supplementation are important fundamentals in preparation for pregnancy. There is growing evidence to avoid valproic acid use during the child-bearing years. Emerging data on congenital malformations and neurocognitive outcomes are available for some of the second-generation antiepileptic drugs and appear reassuring for lamotrigine and levetiracetam. Also reviewed are the benefits of postpartum drug tapers and favorable breastfeeding facts. Counseling the mother and her family on medication choices enables the healthcare team to implement informed decisions that are beneficial for the mother and child.
育龄期往往是癫痫女性一生中管理最为关键的时期。本文回顾了许多不同研究的结果，这些研究结果使医疗团队能够在这些关键时期做出自信的决策并给出建议。孕前规划、有效的避孕措施和叶酸补充是为怀孕做准备的重要基础。越来越多的证据表明，应避免在育龄期使用丙戊酸。关于一些第二代抗癫痫药物的先天性畸形和神经认知结果的新数据已经出现，拉莫三嗪和左乙拉西坦的数据似乎令人放心。本文还回顾了产后逐渐减少药物剂量的益处以及有利的母乳喂养情况。就药物选择向母亲及其家人提供咨询，能使医疗团队做出对母亲和孩子都有益的明智决策。
