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孕期抗癫痫药物

Antiseizure Medications in Pregnancy.

作者信息

Moise Alexandra C, Gerard Elizabeth E

机构信息

Department of Neurology, Feinberg School of Medicine, Northwestern University, 710 North Lake Shore Drive, 11th Floor, Abbott Hall, Chicago, IL 60611, USA.

Department of Neurology, Feinberg School of Medicine, Northwestern University, 710 North Lake Shore Drive, 11th Floor, Abbott Hall, Chicago, IL 60611, USA.

出版信息

Obstet Gynecol Clin North Am. 2023 Mar;50(1):251-261. doi: 10.1016/j.ogc.2022.10.014.

Abstract

Epilepsy affects up to 15 million of people assigned female at birth of childbearing age globally. Up to 65% of these people with epilepsy and gestational capacity have an unplanned pregnancy. Seizure control during pregnancy is important for both the childbearer's and fetus' safety. There are multiple antiseizure medications (ASMs) that can be used to control epilepsy; however, each medication has its own teratogenic risk profile, which must be considered. The majority of these ASMs will require frequent plasma concentration monitoring during pregnancy with corresponding dosage adjustments. Dosages can be reduced back to prepregnancy levels within 3 weeks postpartum. Breastfeeding on ASMs is recommended.

摘要

全球范围内,癫痫影响着多达1500万育龄期出生时被指定为女性的人。这些有癫痫且具备妊娠能力的人中,高达65%会意外怀孕。孕期控制癫痫发作对产妇和胎儿的安全都很重要。有多种抗癫痫药物(ASMs)可用于控制癫痫;然而,每种药物都有其自身的致畸风险特征,必须予以考虑。这些抗癫痫药物中的大多数在孕期都需要频繁监测血浆浓度并相应调整剂量。产后3周内可将剂量降至孕前水平。建议在服用抗癫痫药物期间进行母乳喂养。

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