Pregnancy in epilepsy: management and delivery

New-onset epilepsy in pregnant women: clinical features and delivery outcomes

INTRODUCTION

Most seizures during pregnancy occur in women who already have epilepsy. Rarely, some women may have their first seizure during pregnancy. The purpose of this study was to investigate the clinical features and pregnancy outcomes in women with new-onset epilepsy during pregnancy.

METHODS

112 pregnant women with epilepsy were prospectively evaluated at the Education - Therapeutic Clinic of the Azerbaijan Medical University, in the neurological and maternity departments of the Clinical Medical Center in Baku over a six-year period. Women were regularly followed by a neurologist and obstetrician till the end of pregnancy. To determine the recurrence of seizures during the pregnancy and after delivery, the women were followed up at least once per three months for a one year period after delivery. Delivery and perinatal outcomes were compared with those of 277 healthy women in the control group (without epilepsy and without registering chronic diseases).

RESULTS

Of the 112 pregnant women with epilepsy, 12 (10.7%) had their first seizures during the pregnancy: 6 in the 1^st, 4 in the 2^nd, 2 in the 3^rd trimester. Women with new-onset epilepsy had increased risk of cesarean section and perinatal hypoxia in offspring, compared with controls (Odds ratio [OR]: 13.57; 95% confidence interval (CI):2.86-64.31 and OR: 3.61; 95 % CI: 1.06-12.27, respectively). The risks of cesarean section and perinatal hypoxia were not increased in women with new-onset epilepsy compared to women with epilepsy before pregnancy (OR 2.64; 95 % CI 0.54-12.93 and OR 2.18, 95% CI 0.61-7.76, respectively).

CONCLUSION

In our cohort, women with new-onset epilepsy may have an increased risk of delivery by cesarean section and perinatal hypoxia compared to pregnant controls. The risks were not increased compared to women with epilepsy before pregnancy. Neonatal hypoxia was associated with delivery by cesarean section.

[Features of maternal behavior in women with epilepsy]

AIM

To study characteristics of maternal behavior in women with epilepsy.

MATERIAL AND METHODS

Twenty-three women with epilepsy, aged 25-35 years, with one or more children, aged 0-10 years, were interviewed. Thirty age-matched women were included in the control group. The following psychological methods were used: the projective test 'Mother and Child', the Scale of the degree of rejection of a child in the family, the Parent Institution Study Test Questionnaire (PARI), the projective methodology 'Unfinished sentences', a method for diagnosing the level of empathic abilities.

RESULTS AND CONCLUSION

The style of child upbringing in women with epilepsy is authoritarian, directive. Often there is egocentrism, fixation on one's own behalf, internal coldness. Mothers with epilepsy have a reduced level of empathy and are irritable, anxious, hyperopic, indulgent, emotionally cold, hypochondriac, uncritical, dependent, devout, conceited.