Ann Gynecol Obstetr Res | Volume 1, Issue 1 | Research Article | Open Access

Obstetric Outcome and Predictors of Pregnancy Loss in Pregnant Women with Epilepsy: A Five-Year Prospective Observational Study

Emarh M1*, Hosni N1, Nofal A1, Al-Ahmar I2 and El-Sayed H3

1Department of Obstetrics and Gynecology, Menoufia University, Menoufia Governorate, Egypt
2Department of Neuropsychiatry, Menoufia University, Menoufia governorate, Egypt
3Department of Pediatrics, Menoufia University, Menoufia Governorate, Egypt

*Correspondance to: Mohamed Emarh 

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Abstract

Objective: To ascertain prospectively the maternal and fetal outcome in women with epilepsy who were on antiepileptic drugs compared to women who stopped medical therapy and to find out predictors of pregnancy loss.
Methods: A five-year prospective study was conducted on 412 patients with epilepsy who were allocated into two groups, group 1 (active disease) which included 234 patients on antiepileptic drugs and group 2 (non-active disease) which included 178 patients who stopped medications before pregnancy. Patients were followed to record maternal and fetal outcome. Data was statistically analyzed.
Results: Higher patients in group 1experienced spontaneous miscarriage (p<0.05), antepartum hemorrhage (p<0.05), pre-eclampsia (p<0.001), delivery by cesarean section (p<0.05), peripartum saizures (p<0.001), postpartum hemorrhage (p<0.05), admission to ICU (p<0.001), venous thromboembolism (p<0.05) and defective lactation (p<0.001) with higher babies suffered congenital malformations (p<0.001), prematurity (p<0.001), low Apgar scores (p<0.001), low birth weight (p<0.05) and admission to NICU (p<0.001) compared to those in group 2. The use of antiepileptic therapy, older maternal age (>33 years), peripartum seizures and admission to ICU were independent predictors of pregnancy loss (p<0.05).
Conclusion: patients with epilepsy even those with non-active disease, experienced higher odds of maternal and fetal complications which are increased with the use of antiepileptic drugs.

Keywords:

Epilepsy; Antiepileptic Drugs; Maternal Outcome; Fetal Outcome; Obstetric Outcome

Citation:

Emarh M, Hosni N, Nofal A, Al-Ahmar I, El-Sayed H. Obstetric Outcome and Predictors of Pregnancy Loss in Pregnant Women with Epilepsy: A Five- Year Prospective Observational Study. Ann Gynecol Obstetr Res. 2018; 1(1): 1002.

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