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Cultura Documentos
W184
EPILEPSY AND PREGNANCY AN OBSTETRIC PERSPECTIVE
K. Arunachalam1 , A. Janarthanan2 . 1 Obstetrics and Gynaecology,
Madha Medical College and Hospital, Chennai, Tamil Nadu, India,
Chennai, Tamil Nadu, India; 2 Stanley Medical College and Hospital,
Chennai, Tamil Nadu, India
Objectives: Each year 20,000 women with epilepsy become
pregnant. This number has grown as marriage rates have increased
for women with epilepsy as parenting has become socially
supported. Pregnancy poses special problems with epilepsy.
Issues related to pregnancy, epilepsy, AntiEpileptic Drugs-usage
management as a whole have been fraught with confusion and
misconceptions. Objective of this study was to clean up some
of these misconceptions and to assess the effects of epilepsy on
pregnancy.
Materials: From Jan 2009 Dec 2009, 70 antenatal women with
H/O Epilepsy were recruited for the study. A detailed history, time
of onset, type of seizure, last episode, Neurologist review, the
type of drugs (mono/polytherapy) seizures in present pregnancy
(trimester-wise) were asked.
Methods: AN care was given in our OPD. II trimester anomaly scan
was done. Combined management with neurologist was carried
out throughout pregnancy. VitK 5 mg OD was given from 36 weeks.
Labour monitored and newborns reviewed by neonatologists.
Inj.VitK was administered immediately after birth of the baby.
Inclusion criteria: Antenatal women with pre existing epilepsy.
Exclusion criteria: New onset seizures due to Eclampsia, Infections,
Metabolic derangements and Patients with structural lesions.
Results: 77.1% women belonged to 2025 years of age with
equal number of Primi and Multigravidae. New onset seizures
only 2.9% and pre-existing epilepsy (97.1%). 54.3% received
monotherapy. Among anti-epileptic drugs T.Carbamazepine was the
most frequently used drug (50%) in our study.
Among 68 patients 5 pts had polytherapy (carbamazepine +
phenytoin). 30% had seizures in III trimester and 60% who received
polytherapy developed seizures.
Intrapartum period was uneventful. 54.3% had vaginal deliveries
and 47.1% were LBW babies.
Congenital anomalies (NTD) in our study were only 2.9%
(meningomyelocele) and occurred in patients taking Phenytoin
sodium.
Conclusions: To optimize pregnancy outcome Seizures should be
well controlled preconceptionally and appropriate Anti Epileptic
Drug as monotherapy in the lowest effective dosage throughout
pregnancy.
W185
MANAGEMENT OF PREGNANCY AND A POSTNATAL PERIOD
IN WOMEN WITH VENOUS THROMBOSES
A.S. Eshalieva1 , E.M. Nosinov2 . 1 National Centre of Maternity and
Childhood Welfare, Bishkek, Kyrgyzstan; 2 Kyrgyz-Russian Slavonic
University, Bishkek, Kyrgyzstan
Objectives: Management of pregnancy and postpartum period in
women with venous thromboses with the purpose of pregnancy
prolongation, successful labor and prevention of PATE.
Materials: 23 pregnant and 36 puerperants with venous
thromboses. The average age of the pregnant women was
28.34.3 years, puerperants was 29.64.0. Gestation age of the
pregnant women with thrombosis: at 12 weeks-in 4 cases (17.4%),
1224 weeks-in 4 (17.4%), 2540 weeks in 15 (65.2%). 8
pregnant women (34.8%) had complicated pregnancy a threatened
abortion, anaemia, acute inammation process. All puerperants
had complications: preeklampsia, anaemia, abruptio placenta, IUFD,
premature birth, PPH, operative delivery, uterus amputation.
Methods: General clinical and obstetrical examination, angiographic research, ultrasonic research of veins, including spectral
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