Читать книгу Clinical Pharmacology and Therapeutics - Группа авторов - Страница 106

KEY POINTS IN THE MANAGEMENT OF PREGNANT WOMEN WITH EPILEPSY

Оглавление

1 Management should begin before conception:Use the lowest effective dose of medicationAvoid valproate before conceptionWithdraw any unnecessary medication and use monotherapy wherever possibleIt may be possible to wean women who have been seizure free for several years and require low doses of medication after careful counselling and discussion with a neurologistDo not change if well controlled and already pregnant

2 Discuss increased incidence of congenital malformations using drug specific rates (Table 1.9). In general, the benefits of drug therapy on mother and foetus outweigh the risks

3 All women require to take folic acid 5 mg preconceptually

4 Antenatal screening for neural tube defects by detailed anatomy scan should be performed at 12 weeks and again at 18–20 weeks

5 Vitamin K supplementation during the last month of pregnancy for enzyme‐inducing anticonvulsants

6 Monitor therapy by seizure frequency and adjust doses accordingly

7 Continue anticonvulsant medication during labour

8 Minimise triggers of seizures

9 Neonate should receive vitamin K and breastfeeding should be encouraged

Clinical Pharmacology and Therapeutics

Подняться наверх