The first edition of a new guide called “Epilepsy In Pregnancy,” written for both women and healthcare professionals, offers recommendations for the treatment and care of expectant mothers with epilepsy. It was recently published by the Royal College of Obstetricians and Gynaecologists (RCOG).
Epilepsy, characterized by a risk of recurrent seizures due to unusual electrical activity in the brain, is considered as one of the most common neurological conditions of pregnancy.
In addition to summarizing evidence on maternal and fetal outcomes in women with epilepsy, and establishing possible guidelines for care in pre-pregnancy and during antepartum, intrapartum and postpartum periods, the guideline emphasizes the need for greater access to specialists and epilepsy awareness among health professionals.
“There is only one epilepsy specialist midwife in England and not everyone has access to an epilepsy specialist nurse,'” Professor Ley Sander, medical director at Epilepsy Society, said in a press release. “Any young woman who is planning to start a family should make it a priority to discuss medication and seizure control with her neurologist.”
This guide, produced by RCOG and supported by several organizations, including the Association of British Neurologists, Epilepsy Action, the Royal College of General Practitioners, Royal College of Midwives, Royal College of Physicians, and SUDEP Action, provides advice and support for women during their pregnancies.
“It is important for women to make sure their midwife and delivery team are aware of their epilepsy and any medication that they are taking. It is also important to discuss individual seizure triggers such as pain, tiredness and over breathing,” Professor Sander said, noting that about 2,500 women with epilepsy give birth in Britain each year.
This guideline does not cover diagnosing epilepsy, classifying seizures, and epilepsy management. In the United Kingdom, this information can be found in the National Institute for Health and Care Excellence clinical guideline, and the Scottish Intercollegiate Guidelines Network publication.
“Care of pregnant women with epilepsy has remained fragmented over recent years,” said Professor Alan Cameron, RCOG’s vice president for clinical quality. “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.”
In Britain, poor control of epileptic seizures resulted in the deaths of 21 pregnant women between 2009 and 2013, the release said.