Objective: To explore the clinical character and perinatal management of pregnancy complicated with epilepsy.rnMethods: The data of twenty pregnant women complicated with epilepsy from January 1995 to December 2011 were analyzed retrospectively.rnResults: The incidence of pregnancy complicated with epilepsy was 0. 08%. The average age was 29. 3 + 4.6 years and average gestational week was 37. 3+3. 3 week. Fifteen cases were diagnosed epilepsy before pregnancy. Two patients who stopped the antiepileptic drugs (AEDs) and five patients who continued the AEDs before and during pregnancy had good seizure control. The other seven patients who discontinued the AEDs had convulsive seizures during pregnancy. One patient was never been treated and had generalized tonic-clonic seizures frequently. Five patients experienced their first seizures during pregnancy. There were no obvious predisposing factors except for one patient with severe viralrn encephalitis. Fourteen patients had cesarean section. The preterm delivery rate, small for gestational age rate and perinatal mortality rate were 20% , 20% and 5% respectively. Follow up of the child horn hy the epilepsy mother showed no mental retardation.rnConclusions: Proper preconception planning and good compliance with antiepileptic drugs are essential for women with epilepsy to have favorable pregnancy outcome. The cooperation of obstetric, neurology and anesthesia doctor is important for pregnant women with epilepsy.%目的 探讨妊娠合并癫痫的临床特点及围产期处理.方法 收集1995年1月至2011年12月北京协和医院产科分娩的妊娠合并癫痫的病例资料,回顾性分析其临床特点和母儿结局,并进行产后母婴随访.结果 妊娠合并癫痫患者20例,占同期分娩妇女总数的0.08%.患者平均年龄(29.3±4.6)岁,平均孕周为(37.3±3.3)周.既往诊断癫痫15例,2例孕前、孕期停药者,5例孕期坚持用药者无癫痫发作,7例孕期自行停药者均在中晚孕期有癫痫发作,1例从未诊治者孕期和产程频繁发作.妊娠期首次发作5例,1例为病毒性脑炎后遗症,其余均无明显诱因.剖宫产分娩者14例.20例新生儿中1例围产儿死亡(5%),早产儿及小于胎龄儿分别为4例,各占20%,无新生儿畸形.随访到14例儿童,智力正常,无认知功能障碍.结论 合理的孕前咨询及规范使用抗癫痫药物是妊娠合并癫痫女性改善妊娠结局的关键.其围产期处理需要产科、神经科、麻醉科多科协作.
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