MANAGEMENT OF EPILEPSY IN PREGNANT WOMEN AT TAM ANH GENERAL HOSPITAL, 2020 - 2026
Main Article Content
Abstract
Background: The management of epilepsy during pregnancy is challenging because it requires balancing optimal seizure control with the teratogenic risks associated with anti-seizure medications (ASMs). In Vietnam, data on clinical practice remain limited.
Objective: To evaluate treatment characteristics and seizure control outcomes among pregnant women with epilepsy managed at Tam Anh General Hospital, Hanoi.
Methods: This retrospective descriptive study included 74 pregnant women with epilepsy who received ASMs between January 2020 and April 2026. Data collected included clinical characteristics, seizure type, treatment regimens before and during pregnancy, seizure control outcomes, and selected pregnancy outcomes.
Results: The mean age of the study population was 32.0 ± 4.98 years (range, 21–48 years), and the mean age at epilepsy onset was 18.63 ± 7.84 years. Generalized-onset seizures accounted for 54.05% of cases, while focal-onset seizures accounted for 45.95%. Before pregnancy, patients received a mean of 2.49 ± 1.13 ASMs (range, 1–5 medications). Following ASM treatment, 54.05% of patients experienced seizure improvement, 24.33% achieved complete seizure freedom, and 21.62% showed no improvement or experienced worsening seizures. Five pregnancies were terminated, including one case associated with uncontrolled seizures. Among the 30 women with available breastfeeding data, 21 breastfed their infants, and most of them (66.67%) received ASM monotherapy. Before pregnancy was diagnosed, 76.2% of patients had been receiving or had previously received valproate; all discontinued or switched to alternative therapy after pregnancy was confirmed. Among the infants born, only one case of a horseshoe kidney was identified, while no congenital abnormalities were detected in the remaining newborns.
Conclusions: Most pregnant women with epilepsy in this study achieved satisfactory seizure control and favorable pregnancy outcomes under appropriate clinical management. Careful selection and individualized optimization of ASM therapy, together with timely medication changes when indicated, play a crucial role in maintaining seizure control while ensuring the safety of both the mother and the fetus.
Keywords
Epilepsy, pregnancy, anti-seizure medications, seizure control
Article Details
References
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