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癫痫症孕妇的产科结局:一项基于医院的纵向研究。

Obstetric outcomes in pregnant women with seizure disorder: A hospital-based, longitudinal study.

作者信息

Kaur Tarang Preet, Sahu Latika, Rathore Asmita M, Bhasin Sangeeta

机构信息

All India Institute of Medical Sciences, Department of Obstetrics and Gynaecology, New Delhi, India.

Maulana Azad Medical College, Department of Obstetrics and Gynaecology, New Delhi, India.

出版信息

Turk J Obstet Gynecol. 2020 Sep;17(3):161-169. doi: 10.4274/tjod.galenos.2020.87300. Epub 2020 Oct 2.

Abstract

OBJECTIVE

To study the association of seizure disorder with adverse obstetric outcome in terms of maternal and perinatal complications.

MATERIALS AND METHODS

This longitudinal study was conducted at Maulana Azad Medical College, New Delhi over 15 months among women attending the antenatal clinic (ANC) outpatient department. Fifty pregnant women with seizure disorder with their first ANC visit before 28 weeks were recruited as the case group, excluding patients with eclampsia. The control group included 120 matched healthy pregnant women. After obtaining informed consent, subjects were recruited and followed till one week postpartum and obstetric outcomes were analyzed.

RESULTS

Women with seizure disorder had significantly increased incidence of severe preeclampsia (cases =8%, controls =0%, p<0.001), antepartum hemorrhage (cases =4%, controls =0%, p<0.001), babies with early neonatal complications such as asphyxia (cases =4.1%, controls =0.5%, p=0.04), respiratory distress (cases =14.5%, controls =5.1%, p=0.02), necrotizing enterocolitis (cases =2.0%, controls =0%, p=0.04), early neonatal death (cases =2.0%, controls =0%, p=0.04) and Neonatal Intensive Care Unit admission (cases =20.8%, controls =8.6%, p<0.001) when compared with women without seizure disorder. No significant difference was observed in rates of induction of labor, cesarean section, abortion, congenital anomalies in babies, still births. Conclusion: Women with seizure disorder are at higher risk of hypertensive disorders, antepartum hemorrhage, and early neonatal complications.

CONCLUSION

Women with seizure disorder are at higher risk of hypertensive disorders, antepartum hemorrhage, and early neonatal complications. Appropriate obstetric, pediatric and neurology care is required during preconception, pregnancy, labor, delivery, and postpartum.

摘要

目的

从孕产妇及围产期并发症方面研究癫痫发作障碍与不良产科结局之间的关联。

材料与方法

这项纵向研究在新德里莫拉纳·阿扎德医学院进行,为期15个月,研究对象为产前检查门诊的孕妇。招募了50名在孕28周前首次进行产前检查的癫痫发作障碍孕妇作为病例组,排除子痫患者。对照组包括120名匹配的健康孕妇。在获得知情同意后,招募研究对象并随访至产后一周,分析产科结局。

结果

与无癫痫发作障碍的女性相比,癫痫发作障碍女性发生重度子痫前期(病例组 = 8%,对照组 = 0%,p<0.001)、产前出血(病例组 = 4%,对照组 = 0%,p<0.001)、患有如窒息等早期新生儿并发症的婴儿(病例组 = 4.1%,对照组 = 0.5%,p = 0.04)、呼吸窘迫(病例组 = 14.5%,对照组 = 5.1%,p = 0.02)、坏死性小肠结肠炎(病例组 = 2.0%,对照组 = 0%,p = 0.04)、早期新生儿死亡(病例组 = 2.0%,对照组 = 0%,p = 0.04)以及新生儿重症监护病房收治(病例组 = 20.8%,对照组 = 8.6%,p<0.001)的发生率显著增加。在引产率、剖宫产率、流产率、婴儿先天性畸形率、死产率方面未观察到显著差异。结论:癫痫发作障碍女性发生高血压疾病、产前出血及早期新生儿并发症的风险更高。

结论

癫痫发作障碍女性发生高血压疾病、产前出血及早期新生儿并发症的风险更高。在孕前、孕期、分娩期及产后需要适当的产科、儿科及神经科护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39ad/7538818/6a81a5ae71c7/TJOG-17-161-g1.jpg

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