Epilepsy during pregnancy in emergency department setting

Sevdimbaş, Sarper and Selen, Acehan and Salim, Satar and Muge, Gülen and Dengiz, İhsan and Topalak, Figen (2026) Epilepsy during pregnancy in emergency department setting. IDEGGYOGYASZATI SZEMLE / CLINICAL NEUROSCIENCE, 79 (1-2). pp. 27-34. ISSN 0019-1442

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Abstract

Background and purpose: Pregnant women diagnosed with epilepsy are in the high-risk group for maternal and neonatal complications. We aimed to analyze pregnant patients admitting to the emergency department (ED) with epileptic seizures, to investigate the treatment regimens applied during pregnancy, and to examine the effects of seizure frequency during pregnancy on neonatal outcomes. Methods: This retrospective study included 53 pregnant epilepsy patients presenting to the ED with seizures. Demographic and clinical data, medication use, outcomes, along with neonatal APGAR scores, were recorded using a standard form. Results: In the study, 32.1% of patients were hospitalized, and 41.5% discontinued their medication, with 47% of this subgroup experiencing hospitalization (p<0.001). Hospitalized patients had higher admission lactate levels (p=0.003). Those with ≥2 seizures during pregnancy had increased neonatal intensive care unit (NICU) admission rates (p=0.041), and their newborns had lower mean birth weights (p=0.008) and gestational ages at birth (p=0.011). 89.2% of patients with ≥2 seizures were not taking medications regularly (p=0.001). 73.7% of patients whose newborns were admitted to the NICU were not taking medications regularly (p<0.001). Newborns of patients not taking medications had lower 1-minute APGAR scores, mean birth weights, and gestational ages at birth (respectively;<0.001, <0.001, <0.001). Conclusion: This study reveals that the hospitalization rates of pregnant patients presenting to the ED with epileptic seizures are significantly affected by factors such as the type of antiepileptic drug used, medication compliance, and admission lactate levels. Additionally, irregular use of medications is associated with higher incidences of seizures during pregnancy and adverse neonatal outcomes.

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