Gebelerde Epilepsi Tedavisi

Year 2020, Volume: 10 Issue: 1, 111 - 115, 31.01.2020

Aygül Tantik Pak

https://doi.org/10.33631/duzcesbed.627171

Abstract

Epilepsi
provake edilmeyen nöbetlerin tekrarlamasıyla oluşan bir beyin hastalığıdır.
Epilepsi dünya popülasyonunun %2’sini etkilemektedir. Epilepsili hastaların
büyük bir kısmı üreme çağındaki kadınlardır. Epilepsi tanılı hastaların,
gebelik sürecinde yönetimi zordur. Yüksek oranda sağlıklı (%92-96) çocuk
doğurmalarına rağmen, prematür doğum, düşük doğum ağırlığı, fetal ve neonatal
ölüm riski, konjenital malformasyonlar ve gelişme geriliği oranları normal
popülasyona göre artış göstermektedir. Genel popülasyona göre kongenital
malformasyonu olan çocuk doğurma oranı epilepsi tanılı gebelerde 2-5 kat daha
fazladır. Nöbetlerin kendisi ve kullanılan antiepileptik ilaçlar fetüsün
sağlığını olumsuz yönde etkileyebilir. Gebelikteki nöbet sayısı arttıkça,
gebelik sonuçları olumsuz olarak etkilenmektedir. Birçok çalışma antiepileptik
ilaçlara doğum öncesi maruz kalma ile hem fiziksel anomaliler hem de nöro
gelişimsel bozulma riski arasında bir ilişki olduğunu göstermektedir. Bu
nedenlerle takip ve tedavide temel amaç; hastanın nöbet tipine uygun, en düşük
dozda ilaç tedavisi altında, maksimum nöbet kontrolünün sağlanarak sağlıklı bir
gebelik sürecinin sürdürülmesi ile sağlıklı bir bebeğin doğumunun sağlanması
olmalıdır.

Keywords

Antiepileptik ilaç, Epilepsi, malformasyon

Epilepsy Treatment in Pregnant Women

Abstract

Epilepsy is a
brain condition characterized by the recurrence of unprovoked seizures.
Epilepsy affects 2% of the world population. The majority of patients with
epilepsy are women of reproductive age. Management of epileptic patient during
pregnancy can be difficult. Even though they give birth to healthy children
most of the times (92-96%), premature birth, low birth weight, fetal and
neonatal death, congenital malformations and growth retardation rate are higher
in epileptic patients than normal population. Congenital malformations are 2–5
times more prevalent in children of epileptic women in comparison with the
general population. Seizures and antiepileptic drugs can have a negative effect
on fetus health. As the number of seizures increases in pregnancy, pregnancy
outcomes are adversely affected. Many studies have shown an association between
prenatal exposure to antiepileptic drugs and increased risk of both physical
anomalies and neurodevelopmental impairment. For these reasons the main purpose
of management of epileptic patient during pregnancy is to choose the most
appropriate antiepileptic medication with lowest effective dose for the patient
to gain maximum seizure control and to maintain a healthy pregnancy period with
the birth of a healthy baby.

Keywords

Antiepileptic Drugs, Epilepsy, Malformation

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