The Use of Anti-epileptic Drugs During Pregnancy
| Autor: | Chung-Lung Wang, 王重隆 |
|---|---|
| Rok vydání: | 2004 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 92 [Background and Literature Review] Epilepsy is one of the common diseases in neurology. In Taiwan, there are around 200,000 people af-fected by epilepsy. 40% of them are women in childbearing age. There are about 1/4 ~ 1/3 of epileptic women whose frequency of seizure in-creases during pregnancy. The increase in frequency of seizure shows no relevance to the type and the duration of seizure during pregnancy, and the frequency of seizure during previous pregnancy. However, the com-pliance is one of the most influential factors, which is determined by not only epilepsy itself, but the choice of anti-epileptic drugs during preg-nancy, the metabolism of anti-epileptic drugs during pregnancy, the ef-fects of anti-epileptic drugs on fetus, the complications in labor, the he-redity of epilepsy, the compatibility of anti-epileptic drugs during lacta-tion, the possible effects on newborn growth and others are topics in women with epilepsy during pregnancy. Review in the literature showed that pregnant women with epilepsy are associated with increased fre-quency of the fetal death (stillbirth or abortion), pre-term laboring, low birth-weight newborns (< 2500g), growth and mental retardation, and the increasing probability of seizure in their children. All of the currently used conventional anti-epileptic drugs are teratogenic. Common minor congenital malformations include orofacial malformations, finger mal-formations, hypospadias and etc. Major congenital malformations include congenital heart defects, neural tube defects and etc. In comparison with the malformation incidence (2 ~ 4%) in general population, those women who have been exposed to anti-epileptic drugs have higher malformation incidence (4 ~ 11%). Thus we need to provide suitable drug consultation to decrease the wrong decision-making among the anxious women with epilepsy due to lack of information. [Objective] The objective of the study was to survey pregnancy-related issues among women with epilepsy. In order to give women with epilepsy correct conceptions, we designed drug consultation information. We hope they can obtain the correct conceptions and the most appropriate attitude to improve the quality of medical care among women with epilepsy. [Methods] Women of age from 18 to 40 living in Tainan area and regu-larly visiting epilepsy clinic in NCKUH were randomly selected as our questionnaire subjects. [Results] One hundred effective questionnaires in total were collected, 32 of them being surveyed by face-to-face interview in epilepsy clinic and 68 of them by telephone interview. 9.1% of pregnant women showed noncompliance. The complications during pregnancy and delivery were rare and were considered as common in general. The survey demon-strated 65% of subjects concerned, or ever concerned about the effects of epilepsy on pregnancy. “The risk of teratogenicity”(78.46%) and “the in-fluence of anti-epileptic drug on fetus”(78.46%) were the most concerned issues. The most needed information or helps were “the drug consulta-tion”(93.85%) and “the knowledge of pregnancy complica-tions”(89.23%). [Conclusion] Our study showed women with epilepsy were highly con-cerned with the influence of anti-epileptic drug on fetus and demanding on obtaining drug consultation as well as information about the complica-tion during pregnancy and delivery. Based on this study, further evalua-tion of the effect of intervention is indispensable for the promotion of the quality care among women with epilepsy. |
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