Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47153#.VGBM82fHRK0
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47153#.VGBM82fHRK0
Author(s)
Neurological
Center of Epileptology, Neurogenetics and Brain Research, University
Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University,
Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Neurological Center of Epileptology, Neurogenetics and Brain Research, University Clinic of Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Epilepsy is one of the
most frequent neurological disorders. In these circumstances, more than 25% of the patients are women of
reproductive age. The aim of our research was to analyze the effectiveness and
safety of antiepileptic therapy in women with epilepsy during pregnancy and to
analyze the pregnancies’ outcomes. We included in our research 121 pregnancies
of 101 women aged at the moment of childbearing about 26.9 ± 4.57 years old.
Idiopathic forms of epilepsy were predominant among all causes—47.1% (р < 0.01). Of all cases, 65.4%
remained seizure-free from generalized tonic-clonic seizures (GTCS), including
69.6% of all idiopathic epilepsy cases and 68.6% among symptomatic ones. The
antiepileptic drugs (AED) dosages were exceeding teratogenic level at the
moment of conception in 54.7% of the cases. Worse control of epileptic seizures
was associated with Benzobarbital (66.7%) and Lamotrigine (50.0%). Women with
epilepsy did not receive specialized neurological therapy before conception in
most cases, which leaded to the usage of AED teratogenic doses and less
effectiveness of AED during pregnancy. It is necessary to plan the pregnancy
and prescribe rational treatment for epilepsy starting at the stage of planning
and during gestation in order to obtain a better seizures control and to
decrease congenital disorders risk in fetus.
KEYWORDS
Cite this paper
Dmitrenko, D. , Shnayder, N. , Kiselev, I. ,
Shulmin, A. , Zhirova, N. , Shapovalova, E. , Kantimirova, E. ,
Bochanova, E. , Veselova, O. , Panina, Y. and Muravieva, A. (2014)
Problems of Rational Therapy for Epilepsy during Pregnancy. Open Journal of Obstetrics and Gynecology, 4, 506-515. doi: 10.4236/ojog.2014.49072.
| [1] | Battino, D., Tomson, T., Bonizzoni, E., Craig, J., Lindhout, D., Sabers, A., et al. (2013) Seizure Control and Treatment Changes in Pregnancy: Observations from the EURAP Epilepsy Pregnancy Registry. Epilepsia, 54, 1621-1627. http://dx.doi.org/10.1111/epi.12302 |
| [2] |
Cantwell, R., Clutton-Brock, T.,
Cooper, G., Dawson, A., Drife, J., Garrod, D., et al. (2011) Saving
Mothers’ Lives: Reviewing Maternal Deaths to Make Motherhood Safer:
2006-2008. The Eighth Report of the Confidential Enquiries into Maternal
Deaths in the United Kingdom. BJOG, 118, 1-203.
http://dx.doi.org/10.1111/j.1471-0528.2010.02847.x |
| [3] | Adab, N., Kini, U., Vinten, J., Ayres, J., Baker, G., Clayton-Smith, J., et al. (2004) The Longer Term Outcome of Children Born to Mothers with Epilepsy. Journal of Neurology, Neurosurgery & Psychiatry, 75, 1575-1583. http://dx.doi.org/10.1136/jnnp.2003.029132 |
| [4] | Cummings, C., Stewart, M., Stevenson, M., Morrow, J. and Nelson, J. (2011) Neurodevelopment of Children Exposed in Utero to Lamotrigine, Sodium Valproate and Carbamazepine. Archives of Disease in Childhood, 96, 643-647. http://dx.doi.org/10.1136/adc.2009.176990 |
| [5] |
Tomson, T., Battino, D.,
Bonizzoni, E., Craig, J., Lindhout, D., Sabers, A., et al. (2011)
Dose-Dependent Risk of Malformations with Antiepileptic Drugs: An
Analysis of Data from the EURAP Epilepsy and Pregnancy Registry. The
Lancet Neurology, 10, 609-617. http://dx.doi.org/10.1016/S1474-4422(11)70107-7 |
| [6] | Shnayder, N.A., Dmitrenko, D.V., Sadykova, A.V., Sharavii, L.K., Shulmin, A.V., Shapovalova, E.A., et al. (2011) Epidemiological Studies on Epilepsy in Siberia. Medical and Health Science Journal, 6, 35-42. http://dx.doi.org/10.15208/mhsj.2010.105 |
| [7] | Harden, C.L., Meador, K.J., Pennell, P.B., Hauser, W.A., Gronseth, G.S., French, J.A., et al. (2009) Management Issues for Women with Epilepsy-Focus on Pregnancy (an Evidence Based Review): II. Teratogenesis and Perinatal Outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia, 50, 1237-1246. http://dx.doi.org/10.1111/j.1528-1167.2009.02129.x |
| [8] | Shnayder, N.A., Pilyugina, M.S., Dmitrenko, D.V., Bochanova, E.N., Shapovalova, E.A., Erikalova, S.A., et al. (2011) Pharmacogenetics of Valproic Acid as Unmodified Risk Factor of Adverse Drug Reactions. Medical and Health Science Journal, 7, 20-28. http://dx.doi.org/10.15208/mhsj.2011.129 |
| [9] | Fairgrieve, S.D., Jackson, M., Jonas, P., Walshaw, D., White, K., Montgomery, T.L., et al. (2000) Population Based, Prospective Study of the Care of Women with Epilepsy in Pregnancy. The British Medical Journal, 321, 675-674. http://dx.doi.org/10.1136/bmj.321.7262.674 |
| [10] | Adamyan, L.V., Kunkina, Yu.B., Zhidkova, I.A. and Kaznacheeva, T.V. (2009) Molecular Mechanisms of Epilepsy’s and Antiepileptic Therapy’s Influence on Woman’s Reproductive System (Review). Reproductive problems Journal, 2, 13-17. [Russian] |
| [11] | Grebenyuk, O.V., Svetlik, M.V. and Alifirova, V.M. (2013) Clinico-Electroencephalographic Predictors of Generalized Seizures Increasing in Gestational and Postnatal Periods. Bulletin of the Russian Academy of Medical Sciences Siberian Branch, 12, 24-30. [Russian] |
| [12] |
Herndandez-Diaz, S., Smith,
C.R., Shen, A., Mittendorf, R., Hauser, W.A., Yerby, M., et al. (2012)
Comparative Safety of Antiepileptic Drugs during Pregnancy. Neurology,
78, 1692-1699.
http://dx.doi.org/10.1212/WNL.0b013e3182574f39 |
| [13] | Kiseleva, L.G., Kalinina, L. and Chumakova, G.N. (2011) The Influence of Mother’s Antiepileptic Therapy on Condition of Fetus and Newborn. Vrach-Aspirant, 45, 363-372. [Russian] eww141110lx |
评论
发表评论