Pregnancy outcomes of refractory epilepsy patients treated with Brain-responsive neurostimulation
| Autor: | Sara C. LaHue, Christopher Skidmore, Fedor Panov, Laura A. Kalayjian, David Millett, Dawn Eliashiv, June Yoshii-Contreras, Joel M. Oster, Vikram R. Rao, Kimford J. Meador, Yi Li, Michael L Martini |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Gestational hypertension Adult Male medicine.medical_specialty Drug Resistant Epilepsy Responsive neurostimulation device Preeclampsia 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Pregnancy Recurrent miscarriage medicine Humans Advanced maternal age Retrospective Studies Eclampsia business.industry Obstetrics Cesarean Section Infant Newborn Pregnancy Outcome Brain medicine.disease Gestational diabetes Pregnancy Complications 030104 developmental biology Neurology Premature Birth Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Epilepsy research. 169 |
| ISSN: | 1872-6844 |
| Popis: | Objective To study the pregnancy outcomes, including obstetric complications and fetal outcomes, in pregnant women with epilepsy (WWE) treated with direct brain–responsive neurostimulation (RNS System). Methods Retrospective review of obstetric outcomes and fetal outcomes in WWE treated with the RNS System at nine comprehensive epilepsy centers in the United States from 2014–2020. In addition, changes in seizure frequency, anti-seizure medications, and RNS System setting adjustments during pregnancy were investigated. Results A total of 10 subjects and 14 pregnancies were identified. The mean age at conception was 30.6 ± 4.3 years old. The mean age at implantation was 29.8 ± 4.4 years old. The mean stimulation charge densities ranged from 1.0 to 3.0 μC/cm2 during pregnancy. Obstetric complications included recurrent miscarriage (1 patient), cesarean section (3 patients) due to preeclampsia, non-reassuring fetal heart rate tracing or prolonged labor, preterm birth (1 patient), and preeclampsia (1 patient). No still birth, gestational hypertension, gestational diabetes, eclampsia, or maternal mortality were observed. No RNS System-exposed pregnancies had major congenital malformations. One offspring had a minor congenital anomaly of cryptorchidism in a pregnancy complicated with risk factors of advanced maternal age and bicornuate uterus. Significance The present study is the first report of RNS System-exposed pregnancies in WWE to date. No major congenital malformations were identified. All of the obstetric complications were within the expected range of those in WWE based on previously published data. The sample size of our study is small, so accumulation of additional cases will further help depict the safety profile of treatment with the RNS System during pregnancy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect