Epilepsy and pregnancy: identifying risks

2021 ◽  
pp. practneurol-2019-002304
Author(s):  
John J Craig ◽  
Shona Scott ◽  
John Paul Leach
Keyword(s):  
Seizure Control ◽  
Medical Complications ◽  
Fetal Malformation ◽  
Behavioural Development ◽  
Fetal Complications ◽  
Psychological Challenge ◽  
In Pregnancy

Pregnancy is a time of physical, physiological and psychological challenge. For women with epilepsy, as well as its potential for joy and fulfilment, pregnancy may bring additional risks and difficulties. Clinicians must anticipate and prevent these complications, ensuring that pregnancy, delivery and motherhood proceed without obstetric or medical complications, using available evidence to balance individual risks of undertreatment and overtreatment. Here we review epilepsy management in pregnancy, identifying some of the known effects of epilepsy and its treatment on gestation, fetal malformation, delivery, and neurocognitive and behavioural development. We outline strategies to reduce obstetric and fetal complications in women with epilepsy, while recognising the sometimes competing need to maintain or improve seizure control. We reinforce the importance of identifying those at highest risk, who may require additional measures or safeguards.

Diabetes in pregnancy

2010 ◽  
pp. 2133-2139 ◽  
Author(s):  
Moshe Hod ◽  
Yariv Yogev
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Glycaemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Retinal Disease ◽  
Medical Complications ◽  
In Pregnancy

Diabetes is one of the most common medical complications in pregnancy: 0.4 to 2% of all births are complicated by pregestational diabetes; about 3% of pregnancies are complicated by gestational diabetes mellitus, with substantially more in some populations. Preconceptional evaluation—this should include evaluation of glycaemic control, blood pressure, retinal disease, renal status, thyroid function, peripheral and autonomic neuropathy, peripheral vascular disease, and hypoglyacemic symptoms....

Hypertensive disorders

ESC CardioMed ◽  
2018 ◽  
pp. 2872-2874
Author(s):  
Renata Cifkova
Keyword(s):  
Blood Pressure ◽  
Laboratory Tests ◽  
Medical Complications ◽  
Pharmacological Management ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Diagnosis Of Hypertension ◽  
In Pregnancy

Hypertensive disorders in pregnancy are the most common medical complications affecting 5–10% of pregnancies worldwide. This chapter discusses the following topics: diagnosis of hypertension, definition and classification of hypertension in pregnancy, additional laboratory tests, management of hypertension in pregnancy, pharmacological management of hypertension in pregnancy, delivery induction, blood pressure postpartum and lactation, and prognosis after pregnancy.

Tales of two midwives: medical conditions of pregnancy that changed our midwifery practice

2020 ◽  
Vol 28 (9) ◽  
pp. 640-643
Author(s):  
Alison Gabrielle Perry ◽  
Anna Merrick
Keyword(s):  
Royal College ◽  
Well Being ◽  
Medical Complications ◽  
Medical Conditions ◽  
Midwifery Practice ◽  
Short Essay ◽  
In Pregnancy

The stories of our lives that bring each of us to a career in midwifery are unique. The stories, once we are midwives, that then influence our careers, are also unique. These stories of care for women characterise the course of our careers and ourselves. A short essay competition to attend the annual Medical Complications in Pregnancy conference 2019 at the Royal College of Obstetricians and Gynaecologists gave two colleagues from London the occasion to reflect on situations from practice where childbirth deviated from the realm of ‘normal’ and into disease. As we become increasingly floored by the global COVID-19 pandemic, the key role of midwives across health, well-being as well as disease is especially stark.

scholarly journals Henoch-Schonlein purpura in pregnancy: A case report

2018 ◽  
Vol 11 (4) ◽  
pp. 195-197 ◽  
Author(s):  
Jean-Maxime Côté ◽  
Rosalie-Sélène Meunier ◽  
Jan-Alexis Tremblay ◽  
Florence Weber ◽  
Michèle Mahone
Keyword(s):  
Case Report ◽  
Henoch Schonlein Purpura ◽  
Childhood Disease ◽  
Fetal Complications ◽  
Pediatric Vasculitis ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura ◽  
In Pregnancy

Henoch-Schonlein purpura is a relatively common pediatric vasculitis. Very few cases of Henoch-Schonlein purpura during pregnancy have been described. Henoch-Schonlein purpura is variable in its presentation, from completely benign to possibly catastrophic complications. This rarely encountered condition in adults can also be a recurrence of a previous childhood disease. We present a case of a pregnant 40-year-old woman with Henoch-Schonlein purpura, resulting in a viable birth with no fetal complications. Her presentation is discussed in detail and a general presentation of Henoch-Schonlein purpura is explored, with particular attention to its rare onset during pregnancy.

Seizure Medications Effects on Fetus, Neonate, and Lactation

2018 ◽  
Author(s):  
Tara A. Lynch ◽  
J. Christopher Glantz
Keyword(s):  
Seizure Control ◽  
Refractory Epilepsy ◽  
Severe Disease ◽  
Medication Use ◽  
Disease Treatment ◽  
Teratogenic Risk ◽  
Antiepileptic Medications ◽  
Patients With Epilepsy ◽  
In Pregnancy ◽  
The Ideal

Medication use in pregnancy requires a careful balance between the risks of fetal teratogenicity and the maternal benefits of disease treatment. For women with epilepsy, there are many antiepileptic medications available for use in pregnancy. Each varies in their safety profile, risk for fetal anomalies, and effectiveness of seizure control. In most scenarios, the benefits of maternal treatment outweigh the risk of fetal effects, especially in cases of refractory epilepsy or severe disease. Many of the newer anti-epileptic drugs appear to have less teratogenic risk than the older medications. The ideal AED is one that is effective from the woman, is least teratogenic, and used at the lowest possible dose. Overall, a detailed understanding of antiepileptic efficacy, the pharmacologic differences in pregnancy, and the potential adverse fetal effects are required for optimal treatment of pregnant patients with epilepsy.

scholarly journals Primary Hyperparathyroidism in Pregnancy: A Two-Case Report and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
A. D. Herrera-Martínez ◽  
R. Bahamondes-Opazo ◽  
R. Palomares-Ortega ◽  
C. Muñoz-Jiménez ◽  
M. A. Gálvez-Moreno ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Early Diagnosis ◽  
Literature Review ◽  
Primary Hyperparathyroidism ◽  
Serum Levels ◽  
Second Trimester ◽  
Uncommon Disease ◽  
Fetal Complications ◽  
In Pregnancy

Primary hyperparathyroidism (PHPT) in pregnant women is an uncommon disease. It could be easily misdiagnosed because of physiologic changes during pregnancy; in some cases, patients could remain asymptomatic maintaining elevated calcium serum levels, and this situation represents a threat to the health of both mother and fetus. We present two cases of PHPT during pregnancy and their evolution after surgical treatment in the second trimester; there were no observed complications during pregnancy or delivery in our patients. Early diagnosis and medical/surgical treatment in PHPT are necessary for avoiding maternal and fetal complications which could not be predicted based on duration or severity of hypercalcemia. An appropriate management of PHPT during pregnancy is necessary for preserving the health of both the woman and the fetus.

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