
Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Introduction: epilepsy is defined as the presence of recurring unprovoked crisis, and whose treatment is typically an antiepileptic drug regimen taken daily for a long time. About 1 in 200 pregnant women develop epilepsy (0.5%). Women with epilepsy have a higher risk of poor outcomes of pregnancy, although most of their children will be normal. In pregnancy, the main risks for the mother and child are the result of poor control of their epilepsy and an elevated risk of major congenital malformations after to antiepileptic treatment. Treatment should be given to control crisis during pregnancy, despite its teratogenic potential, since the effects of epilepsy crisis are much more harmful to both mother and fetus. The treatment has to be administered as monotherapy, with minimal and effective doses able to control the crisis. In addition to the antiepileptic treatment, it is essential for the pregnant woman to be treated with folic acid at prophylactic doses of 0.4 mg daily and vitamin K with dose of 20 mg daily for the last month of pregnancy in order to prevent neural tube defects and maternal and fetal bleeding. It should also be given to the newborn immediately with a dosage of 1mg IM. The objective of this study was to determine treatment regimens that can be used to control epilepsy in pregnant women, and other measures to be taken in order to minimize the risks to the mother and fetus.
REFERENCIAS BIBLIOGRÁFICAS
Harden CL, Hopp J, Ting TY, Pennell PB, French JA, et al.
American Academy of Neurology; American Epilepsy Society. Practice parameter update: management issues for women with epilepsy-focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology. 2009 july 14; 73(2):126-32
Katchanov J, Birbeck G. Epilepsy care guidelines for low- and middle- income countries: From WHO mental health GAP to national programs. BMC Medicine. 2012; 10:107
Lorenzato R, Cavalli R, Duarte G, Sakamoto A, Mauad F, Nogueira A. Epilepsy and Pregnancy: Evolution and Fetal outcome. RGBO. 2002; 24 (8):521-526
Meador K, Baker G, Browning N, Clayton-Smith J, Combs- Cantrell D, el al. Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic Drugs. N Engl J Med. 2009; 360;(16):1597-1605
Hill DS, Wlodarczyk BJ, Palacios AM, Finnell RH. Teratogenic effects of antiepileptic drugs. Expert Rev Neurother. 2010 jun;10(6):943-59
Sachdeva P, Patel B.G, Patel B.K. Drug Use in Pregnancy; a Point to Ponder. Indian Journal of Pharmaceutical Sciences. 2009 jan-feb; 71(1): 1–7
Weil S, Deppe C, Noachtar S. The treatment of women with epilepsy. Deutsches Ärzteblatt International. 2010; 107(45):787–93
Boon P, Engelborghs S, Hauman H, Jansen A, Lagae L, Legros B, et al. Recommendations for the treatment of epilepsy in adult patients in general practice in Belgium: an update. Acta Neurol Belg. 2012 jun; 112(2):119-31
Tomson T, Battino D. Teratogenic effects of antiepileptic drugs. Lancet Neurology. 2012 sep; 11(9):803-13
Colmes L, Harvey E, Coull B, Huntington K, Khoshbin S, Hayes A, M.D., Ryan L. The Teratogenicity of Anticonvulsant Drugs.
New England Journal of Medicine 2001;344(15):1132-1138
Matlow J, Koren G. Is carbamazepine safe to take during pregnancy? Can Fam Physician. 2012; feb; 58(2):163-4
Jentink J, Dolk H, Loane MA, Morris JK, Wellesley D, et al. EUROCAT Antiepileptic Study Working Group. Intrauterine exposure to carbamazepine and specific congenital malformations: systematic review and case-control study. BMJ. 2010 dec; 2:341
Meador KJ, Penovich P, Baker GA, Pennell PB, Bromfield E, et al. NEAD Study Group. Antiepileptic drug use in women of childbearing age. Epilepsy Behav. 2009 jul; 15(3):339-43
Man S-L, Petersen I, Thompson M, Nazareth I. Antiepileptic Drugs during Pregnancy in Primary Care: A UK Population Based Study. 2012; PLoS ONE 7(12): e52339
Reimers A, Brodtkorb E. Second-generation antiepileptic drugs and pregnancy: a guide for clinicians. Expert Rev Neurother. 2012; jun;12(6):707-17
Dean JCS; Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth; J Med Genet 2002;39: 251-59
Bruno M, Harden C. Epilepsy in Pregnant Women. Current Treatment Options in Neurology. 2002; 4(1):31-40
Adab N, Tudur S, Vinten J, Williamson PR, Winterbottom JB.
Common antiepileptic drugs in pregnancy in women with epilepsy (Review). Cochrane Database Syst Rev. 2012; (6):1-44
Practice Parameter update: Management issues for women with epilepsy-Focus on pregnancy (an evidence-based review): Vitamin K, folic acid, blood levels, and breastfeeding. Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009; 73:142-149
Kazmin A, Wong R, Sermer M, Koren G Antiepileptic drugs in pregnancy and hemorrhagic disease of the newborn. Canadian Family Physician. 2010; (56):1290-1292
The authors who publish in this journal accept the following conditions:
1. The authors retain the copyright and grant to the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM the right of the first publication, with the work registered with the Creative Commons attribution license, which allows third parties to use the published material provided that they mention the authorship of the work and the first publication in this journal.
2. Authors can make other independent and additional contractual agreements for the non-exclusive distribution of the version of the article published in this journal (for example, include it in an institutional repository or publish it in a book) as long as it clearly indicates that the work was published. for the first time in the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM.