The management of epilepsy in pregnancy at the Whittington Hospital: a retrospective audit 2004-2006 and 2007-2010

Knowledge of neurologists and gynaecologists regarding reproductive and maternity issues in women with epilepsy

Background: Epilepsy is one of the most common neurological disorders, with more than 400,000 individuals in Poland (about 1% of the population) affected. Epilepsy complicates approximately 0.5% of pregnancies. Objective: To determine the level of knowledge that neurologists and gynaecologists have about reproductive and maternity issues for women with epilepsy. Material and methods: This study included 141 neurologists and physicians undergoing specialist training in neurology as well as 72 gynaecologists and physicians undergoing specialist training in gynaecology. A validated questionnaire was used to survey these neurologists and gynaecologists, who worked in Silesia Province. Results: In the group of physicians advising on contraception, significantly (p=0.003) more gynaecologists than neurologists recommended hormonal birth control. Significantly more (p=0.031) neurologists than gynaecologists believed that monotherapy with antiepileptic medications should be aimed for before a planned pregnancy in women with epilepsy. More than a half of the surveyed physicians (56.8%) believed that pregnant women with epilepsy can have a natural delivery. Conclusions: On the basis of these results, we have concluded that gynaecologists and, to a lesser extent, neurologists should have more extensive knowledge regarding reproductive and maternity issues for women with epilepsy. We further propose that close collaboration between neurologists and gynaecologists in the care of epileptic women is necessary.