Submitted by : Shirisha
#Epilepsy-
Incidence-0.5-1%
Status epilepticus-1% of this
10fold increase r/o death- mc d/t SUDEP
MCC of death in labour is d/t gtcs
Na valproate – mcc for major congenital anomaly. Also for neurodevelopmental problems in the baby.(childhood autism)
Recurrence rate of major congenital anomaly-16.8%
67% WWE with seizures will not worsen in pregnancy
WWE with 10yrs seizure free(5yrs off AED)- reclassified to non-epileptic
Folic acid to be started from 3m(not 1m) before conception to 3m after (5mg/day)
WWE on AED has increased r/0
Fgr(3.5times higher.do serial growth scan)
iol
PPH
NICU admission
Wwe on AED polytherapy has increased r/o cs
Seizure in labour:
R/0- 1-2%
Doc- bzd(clobazam)
Analgesia- do not give pethidine im
and in GA- pethidine ,ketamine,sevo to be avoided
Postpartum seizures more by 1-2%above intrapartum
If AED dose was increased in pregnancy-liaise with neurologist within 10days to prevent AED toxicity.
