Status epilepticus related to pregnancy: Devising a protocol for use in the intensive care unit

摘要

Background: Status epilepticus ( SE) related to pregnancy is rare and carries a significant risk to both the mother and the fetus. Objectives: We conducted this study to devise a protocol for the management of SE related to pregnancy in a cohort of female patients admitted with SE during pregnancy. Materials and Methods: All women who developed SE related to pregnancy ( gestation, labor, and puerperium) between January 2000 and December 2016 were included. Data was collected using a structured proforma. Results: There were 17 women who had SE related to pregnancy, of whom 10 had refractory SE. The various causes of refractory SE were eclampsia ( N = 2), posterior reversible encephalopathy syndrome ( PRES) due to various causes other than eclampsia ( N = 3), cortical venous thrombosis ( CVT) [ N = 3], subarachnoid hemorrhage ( SAH) [ N = 1], and N-methyl-D-aspartate ( NMDA) receptor antibody-mediated encephalitis ( N = 1). Six out of 10 women with refractory SE ( 60%) and five out of 10 fetuses ( 50%) had a good outcome. Conclusion: There is a dearth of literature with regards to SE related to pregnancy and little or no guidelines exist for its management. Awareness about the diverse etiologies other than eclampsia is important. A protocol-based approach to the diagnosis and management of SE is necessary to ensure best outcomes.