Original scientific paper

https://doi.org/10.20471/acc.2016.55.04.02

The Croatian model of integrative prospective management of epilepsy and pregnancy

Snježana Miškov ; Clinical Department of Neurology and Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Romana Gjergja Juraški ; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Srebrnjak Children's Hospital, Zagreb, Croatia
Ivan Mikula ; Sveta Katarina Hospital, Zabok, Croatia
Silvio Bašić ; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Dubrava University Hospital, Zagreb Croatia
Marija Bošnjak Pašić ; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek Croatia; Zagreb University Hospital Center, Clinical Department of Neurology, Zagreb, Croatia
Vesna Košec ; Clinical Department of Neurology and Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Zlatko Sabol ; Sabol Pediatric Clinic, Zagreb, Croatia
Aleksandra Fučić ; Institute of Occupational Health and Research, Zagreb, Croatia
Tomislav Sajko ; Clinical Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Vanja Bašić Kes ; Clinical Department of Neurology and Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

Abstract

Epilepsy is the most common neurological complication in pregnancy. Women with epilepsy have a higher risk of complications in pregnancy. In Croatia, women with epilepsy are treated by neurologists at tertiary centers according to the place of residence. We prospectively followed-up pregnancies in women with epilepsy and healthy controls, and analyzed the factors responsible for their delivery outcomes and development of their babies. Healthy pregnant women had a higher level of education and economic status, but pregnant women with epilepsy took folic acid in a higher proportion than controls, possibly due to timely preconception counseling. Complications during pregnancy depended on the number of antiepileptic drugs and epilepsy control. We noticed some behavioral and cognitive aspects in children exposed in utero to valproic acid, which required follow up. The rate of congenital malformations was not increased. In conclusion, women with epilepsy should receive preconception counseling about the risk for pregnancy, but also about the possibilities to minimize that risk. We have introduced a model of integrative management of pregnancy and epilepsy based on close collaboration among different clinical experts in Croatia, in order to
provide prompt counseling and timely intervention.

Keywords

Epilepsy; Pregnancy; Antiepileptic drugs; Seizures; Congenital malformations

Hrčak ID:

177863

URI

https://hrcak.srce.hr/177863

Publication date:

15.12.2016.

Article data in other languages: croatian

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