Pregnancy and epilepsy: focus on seizure frequency changes and obstetric complications. Progress in studies and lag in practice

Abstract

Epilepsy is a common neurological disease that negatively affects all areas of life, with a need to take antiepileptic drugs (AEDs) for a long time and with a high incidence of side effects.Objective: to determine the main directions of studies dealing with the problem of pregnancy in epilepsy, by analyzing their results.Material and methods. Over past 10-year publications on pregnancy in epilepsy, their prospects for and prognostic significance for solving scientific and practical problems underwent an analytical review.Results and discussion. It was found that the risk for higher frequency of seizures was 15 times lower if the latter were controlled within 9–12 months before pregnancy. AED therapy noncompliance during pregnancy is the cause of relapses, increased seizure frequency, and status epilepticus. Changes in the blood concentrations of AED during pregnancy require therapeutic drug monitoring and correction of daily dosages of these drugs. The indication for caesarean section in epilepsy is a high perinatal and maternal risk. Breastfeeding in maternal epilepsy is indicated applying a personalized approach. Studying the predictors of changes in the frequency of seizures and improving pregravid preparation are promising areas for optimizing pregnancy outcomes in epilepsy.