Epilepsy during pregnancy: focus on management strategies.
Epilepsy during pregnancy: focus on management strategies.
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DOI：
10.2147/ijwh.s98973
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Bainbridge JL
中科院分区：
文献类型：
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作者：
Borgelt LM;Hart FM;Bainbridge JL
在美国，超过一百万的癫痫女性是生育年龄，每年有20,000多名婴儿。怀孕的癫痫患者有并发症的风险，包括癫痫发作频率的变化，孕产妇发病率和死亡率以及由于抗癫痫药的暴露而引起的先天异常。怀孕期间癫痫的适当治疗可能涉及频繁监测抗癫痫药血清浓度，潜在的抗癫痫药物的先选先男性切换，进行剂量调整，以更频繁的给药最大程度地减少峰值药物浓度，并避免潜在的致病性药物。理想情况下，将进行孕前计划，以最大程度地降低怀孕期间母亲和胎儿的风险。重要的是要认识到当前和新兴疗法的益处和风险，尤其是在处方药产品信息中修订的妊娠标签。这篇综述将概述怀孕期间癫痫的风险，审查领先组织的各种建议，并提供一种基于证据的方法来管理癫痫患者在怀孕之前，期间和怀孕后。
In the US, more than one million women with epilepsy are of childbearing age and have over 20,000 babies each year. Patients with epilepsy who become pregnant are at risk of complications, including changes in seizure frequency, maternal morbidity and mortality, and congenital anomalies due to antiepileptic drug exposure. Appropriate management of epilepsy during pregnancy may involve frequent monitoring of antiepileptic drug serum concentrations, potential preconception switching of antiepileptic medications, making dose adjustments, minimizing peak drug concentration with more frequent dosing, and avoiding potentially teratogenic medications. Ideally, preconception planning will be done to minimize risks to both the mother and fetus during pregnancy. It is important to recognize benefits and risks of current and emerging therapies, especially with revised pregnancy labeling in prescription drug product information. This review will outline risks for epilepsy during pregnancy, review various recommendations from leading organizations, and provide an evidence-based approach for managing patients with epilepsy before, during, and after pregnancy.