The New Indian Journal of OBGYN. 12(1):55-59

A study on maternal and fetal outcome in epilepsy complicating pregnancy in a tertiary care centre

AR Jameela Ponmalar, Rema V Nair, Raagavi Sri S

ABSTRACT

Objectives: The purpose of this study is to determine maternal and fetal outcome in pregnant women with epilepsy (WWE). Antenatal care is done with multidisciplinary approach with preconception counseling by neurologist, about need to continue antiepileptic drugs (AED) with same or reducing dose. This prospective study was done by evaluating number of women who had generalized tonic clonic seizures, partial seizures, who were on monotherapy and polytherapy, who had term and preterm deliveries, underwent normal delivery and caesarean sections and babies with growth restriction or major congenital malformations (MCM). Materials and methods: This study was conducted in antenatal clinic, neurology clinic, obstetric wards and labour room at tertiary care hospital in Kulasekharam from January 2022 - August 2022. A total of 100 pregnant WWE were recruited which includes newly diagnosed epilepsy after 20weeks of gestation, at each trimester for seizure episodes on women with treated epilepsy and during postnatal period for intrauterine growth restriction and congenital abnormalities in babies born to women with treated epilepsy were recorded. Result: 100 pregnant WWE were studied over period of one year. Among women on antiepileptic drugs 60% had seizures. Emergency LSCS was reported in 21% of pregnant WWE, (64%) received monotherapy. There were no major congenital malformations (MCM) and 1 intrauterine death in our study. MCM was highest with valproate, 25% were preterm and 30% were low birth weight of <2,500gm. Conclusion: Pregnant WWE should receive multidisciplinary approach; risk of maternal and fetal complications can be reduced by preconceptional counseling, management during antenatal and postnatal period to reduce the risk of complications involving both mother and neonate.