INTRODUCTION:
Epilepsy is the commonest neurological disorder seen in clinical practice. The incidence of epilepsy is 44 per 100,000 person years. The incidence in females, is 41 per 100,000 person years, and for males is 49 per 100,000 person years. The prevalence of epilepsy was slightly higher in males than females (6.5 vs 6.0 per 1000 persons) in the epileptic study reported at Rochester. In India people affected by epilepsy are more than 10 millions, constituting a prevalence of about 1% of the population. There are 2.73 million women with epilepsy in India and about 52% of them are in the reproductive age group.
AIM OF THE STUDY:
1. To study the alteration of seizure frequency during pregnancy.
2. To study the outcome of pregnancy in women with epilepsy.
3. To study the outcome of delivery in epileptic pregnant women.
4. To study the effect of epilepsy, and antiepileptic drugs on the foetus and neonate.
5. To compare the outcomes of pregnancy in patients with or without preconceptal counseling.
MATERIALS AND METHODS:
Material/selection of subjects: WWE in the reproductive age group who were planning pregnancy or became pregnant were included in the study. Patients with epilepsy attending epilepsy clinic at Institute of Neurology Chennai and also RIOGH Egmore who were on antiepileptic drugs before and during pregnancy were enrolled. All patients followed up through out the course of pregnancy, and 3 months postpartum.
Exclusion Criteria:
Patients with first episode of seizure during pregnancy, seizure due to complications of diabetes or hypertension, or taking antiepileptic drugs after the first trimester were excluded.
CONCLUSION:
1. Most of our pregnant patients had good seizure control before and during pregnancy.
2. In those with poor seizure control prior to pregnancy had improved seizures during pregnancy, due to stringent monitoring and care.
3. Status epilepticus occurred in one patient.
4. Most of our patients had successful vaginal delivery, in those who had caesarian section it was done for non neurological indication like cephalopelvic disproportion, foetal distress.
5. During postpartum period only four of them developed seizures.
The incidence of congenital malformations, CM risk is 5.6% on monotherapy,10.0% on two drug regimen,12.5% on polytherapy. There was no neonatal deaths.
It is important to educate pregnant women with epilepsy for proper planning of their pregnancies, for preconceptal folic acid intake, AED intake during the course of pregnancy, and also monitor with high resolution ultrasound for the detection of congenital malformations
