Epilepsy during pregnancy guidance released

Published on: 29/06/2016

New guidelines have been released from the Royal College of Obstetricians and Gynaecologists relating to the management of epilepsy during pregnancy.

 

Whilst most women with epilepsy deliver healthy babies safely, the 2014 MBBRACE-UK report called for urgent guidelines to support professionals in doing more to manage the condition during pregnancy.

 

Epilepsy is one of the most common neurological conditions during pregnancy, affecting 1% of the UK population. The guidelines comes after 21 women died during pregnancy as a result of epilepsy during 2009 and 2013, as reported in the 2014 MBBRACE-UK report.  In most of the cases, deaths were the result of poorly controlled seizures.

 

The guidelines recommend a range of elements to be involved in a women’s care, including a review of anti-epileptic medication under the advice of their GP and/or specialist team. Determining the appropriate dosage will take into account to lowest effective dose, to control seizures and minimise risk to an unborn baby. Advice should be sought pre-conception or as soon as a woman is aware that she is pregnant.

 

Recommendations also include a higher dose of folic acid, giving birth in a consultant-led unit with one-to-one midwifery care and access to a special care baby unit, incase required. Woman should also receive additional post-natal care, with monitoring for seizure triggers such as depression and sleep deprivation, and a prompt review of their medication dosage.

 

Professor Alan Cameron, RCOG Vice President for Clinical Quality, said:

“Care of pregnant women with epilepsy has remained fragmented over recent years. This is the first ever national guideline on epilepsy and pregnancy and we hope it will support healthcare professionals to ensure that women receive the appropriate counselling before, during and after pregnancy and are aware of the risks to themselves and their baby and the benefits of appropriate treatment. Such a strategy will empower women to make informed decisions about their care during pregnancy with the support from a specialist team.”

 

Read the patient information guidelines here.

 

Read the full article here.