妊娠合并癫痫患者的临床特征及处理对策

Clinical characteristics and treatments of epilepsy during pregnancy

目的探讨妊娠合并癫痫患者的临床特征及处理对策。方法收集2010-02—2015-12我院产科分娩的62例妊娠合并癫痫患者的临床资料进行回顾性分析。结果症状性癫痫21例,隐源性癫痫36例,特发性癫痫5例;孕前停药5例,坚持规律服药42例,其中单药治疗24例,多药治疗18例,未坚持服药15例;妊娠期癫痫发作增加17例(27.4%),发作减少19例(30.7%),发作无变化26例(41.9%);自然分娩33例(53.2%),剖宫产29例(46.8%);新生儿窒息3例,低体质量儿4例,新生儿畸形1例。结论癫痫患者孕前进行咨询及评估,规范化抗癫痫药物治疗,妊娠期增加产检次数,多学科合作管理,可以降低母儿并发症,改善妊娠结局。

Objective To investigate clinical characteristics and treatments of epilepsy during pregnancy. Methods We ret rospectively analyzed the clinical data of 62 pregnant women with epilepsy who were in obstetrical department from February 2010 to December 2015. Results Of the 62 selected cases,there were 21 cases with symptomatic epilepsy,36 with cryptogenic epilepsy and 5 with idiopathic epilepsy. In addition, 5 patients stopped the antiepileptic drugs（AEDs）before pregnancy and 42 patients regu larly continued the AEDs among whom 24 patients were treated with monotherapy, 18 patients were treated with multi-drug medi cation and 15 patients did not adhered to AEDs. Seizures during pregnancy increased in 17 patients（27.4%）, reduced in 19 patients （30.7%） and remained unchanged in 26 patients （41.9~）. 33 patients （53.2%）received natural childbirth, while 29 patients （46.8^）received cesarean section. There were 3 infants of neonatal asphyxia,4 infants of low-birth weight,and one infant of neonatal malformation. Conclusion Complications in both mothers and neonates can be reduced and pregnancy outcome can be improved by carrying out consultation and evaluation before pregnancy, standardizing treatment of AEDs, enhancing the number of obstetric examination during pregnancy and strengthening multidiscipiinary cooperative management.