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Epilepsia na gravidez : uma realidade cada vez mais segura : revisão da literatura
Orientador(es)
Resumo(s)
A epilepsia representa a patologia neurológica mais comum na gravidez e é definida pela presença de crises convulsivas não provocadas e recorrentes que obriga a um tratamento diário com fármacos antiepiléticos (FAE). A incidência da epilepsia é de 0,3-0,5% em diferentes populações em todo o mundo. Os desfechos obstétricos e neonatais nas mulheres com epilepsia (MCE) são geralmente piores quando comparados com as mulheres sem epilepsia. Não se sabe ainda se é devido à epilepsia per se ou aos FAE. Há uma preocupação generalizada sobre os riscos teratogénicos colocados pelos FAE. Tendo em conta que mais de metade das gestações de MCE não são planeadas deve haver uma educação continuada destas mulheres para que a melhor escolha de FAE seja feita antes da gravidez. Durante a gravidez, os médicos têm a difícil tarefa de garantir o controlo das convulsões, minimizando possíveis efeitos adversos dos FAE no feto tendo ainda em conta os desfechos obstétricos e neonatais. O objetivo desta revisão literária da informação existente até à data é fornecer uma atualização relativamente à orientação das mulheres com epilepsia, antes e durante a gravidez. E esperamos que a compreensão de como a epilepsia altera a gravidez contribua para atenuar as consequências desta doença.
Epilepsy is the most common neurological disorder in pregnancy and it is de-fined by the presence of unprovoked and recurrent seizures that requires daily treatment with antiepileptic drugs (AED). The incidence of epilepsy is 0.3-0.5% in different popu-lations around the world. Both obstetric and neonatal outcomes in women with epilepsy (WWE) are usually worse when compared to women without epilepsy. It is not known whether it is due to epilepsy or to AED. There is a widespread concern about the teratogenic risk posed by AED, given that more than half of the pregnancies in women with epilepsy are not planned the continuous education of these women is important so that the best choice of AED is made before pregnancy. During pregnancy, doctors have the difficult task of ensuring seizure control while minimizing possible adverse effects of AED in the fetus and taking into account the obstetrical and neonatal outcomes. The purpose of this literature review is to provide an update regarding the management of women with epilepsy before and during pregnancy. And we hope that the understanding of how epilepsy changes pregnancy contributes to the mitigation of the adverse outcomes of this disease.
Epilepsy is the most common neurological disorder in pregnancy and it is de-fined by the presence of unprovoked and recurrent seizures that requires daily treatment with antiepileptic drugs (AED). The incidence of epilepsy is 0.3-0.5% in different popu-lations around the world. Both obstetric and neonatal outcomes in women with epilepsy (WWE) are usually worse when compared to women without epilepsy. It is not known whether it is due to epilepsy or to AED. There is a widespread concern about the teratogenic risk posed by AED, given that more than half of the pregnancies in women with epilepsy are not planned the continuous education of these women is important so that the best choice of AED is made before pregnancy. During pregnancy, doctors have the difficult task of ensuring seizure control while minimizing possible adverse effects of AED in the fetus and taking into account the obstetrical and neonatal outcomes. The purpose of this literature review is to provide an update regarding the management of women with epilepsy before and during pregnancy. And we hope that the understanding of how epilepsy changes pregnancy contributes to the mitigation of the adverse outcomes of this disease.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Epilepsia Gravidez Obstetrícia Ginecologia