Dmitrenko, D.V., Shnayder, N.A., Kiselev, I.A., Shulmin, A.V., Zhirova, N.V., Shapovalova, E.A., Kantimirova,E.A., Bochanova, E.N., Veselova, O.F., Panina, Y.S. and Muravieva, A.V. (2014) Problems of Rational Therapy for Epilepsy during Pregnancy. Open Journal of Obstetrics and Gynecology, 4, 506-515.
http://dx.doi.org/10.4236/ojog.2014.49072

Abstract
Epilepsy is one of the most frequent neurological disorders. In these circumstances, more than 25% of the patients are women of reproductive age. The aim of our research was to analyze the effectiveness and safety of antiepileptic therapy in women with epilepsy during pregnancy and to analyze the pregnancies’ outcomes. We included in our research 121 pregnancies of 101 women aged at the moment of childbearing about 26.9 ± 4.57 years old. Idiopathic forms of epilepsy were predominant among all causes—47.1% (р < 0.01). Of all cases, 65.4% remained seizure-free from generalized tonic-clonic seizures (GTCS), including 69.6% of all idiopathic epilepsy cases and 68.6% among symptomatic ones. The antiepileptic drugs (AED) dosages were exceeding teratogenic level at the moment of conception in 54.7% of the cases. Worse control of epileptic seizures was associated with Benzobarbital (66.7%) and Lamotrigine (50.0%). Women with epilepsy did not receive specialized neurological therapy before conception in most cases, which leaded to the usage of AED teratogenic doses and less effectiveness of AED during pregnancy. It is necessary to plan the pregnancy and prescribe rational treatment for epilepsy starting at the stage of planning and during gestation in order to obtain a better seizures control and to decrease congenital disorders risk in fetus.

Keywords
Epilepsy, Women, Pregnancy, Anticonvulsants, Rational Therapy, Outcomes