- Epilepsy is the most common serious neurological problem encountered in pregnancy; however, women with epilepsy are often not referred to high-risk pregnancy services.
- The 2015 Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) report on maternal mortality highlights that the care of pregnant women with epilepsy requires urgent improvement.
- The two most recently available guidelines (Scottish Intercollegiate Guidelines Network and Royal College of Obstetricians and Gynaecologists guidelines) require comparative critical appraisal.
- Collaboration between general practitioners, specialist epilepsy nurses/midwives, obstetricians, obstetric physicians, neurologists and anaesthetists is vital to ensure optimal standardised management.
- To understand the role of pre-conception counselling: to include advice on seizure control, anti-epileptic drugs (AEDs) and pre-conception folic acid.
- To understand the risk factors associated with poor outcomes in pregnant women with epilepsy.
- To understand the risks associated with specific types of AEDs: mono- and polytherapy.
- To understand the issues regarding the titration of AEDs during pregnancy, postnatal and breastfeeding periods.
- To understand the importance of a multidisciplinary antenatal, intrapartum and postnatal schedule of care and special considerations.
- When should we advise women to avoid pregnancy?
- When, how and by whom should AEDs be modified?
- Are women with epilepsy aware of the risk of sudden unexpected death in epilepsy in pregnancy?
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via The management of pregnant women with epilepsy: a multidisciplinary collaborative approach to care – Bhatia – 2017 – The Obstetrician & Gynaecologist – Wiley Online Library