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Management of epilepsy in pregnancy: a report from the International League Against Epilepsy Task Force on Women and Pregnancy Volume 21, issue 6, December 2019

TEST YOURSELF

(1) What is the risk of major congenital malformations in offspring after maternal use of valproate?

 

(2) Why is it important for women with epilepsy taking AEDs to also take periconceptional folate?

 

(3) Serum concentrations of many antiepileptic drugs tend to decrease during pregnancy. What level of decrease is associated with a significant risk of deterioration in seizure control?

 

(4) Provide the 2 most frequent causes of breakthrough seizures during pregnancy.

 

(5) Which of the statements below are not true:

A. During the newborn period bathing of the baby with the mother alone should be avoided

B. During the newborn period the mother should priviliege using a baby carrier when walking around with the baby

C. Breastfeeding should be prohibited

D. In the early postpartum period, the mother should also be discouraged from taking a bath by herself behind a closed, locked door or when no other adult is around.

 

 

 

 

 

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Answers

(1) The risk is approximately 10% according to prospective pregnancy registries, but it is dose-dependent.

 

(2) Studies indicate positive effects of periconceptional folate supplementation in these women regarding neurodevelopmental and behavioural outcomes in their children.

 

(3) A decrease by >35% from pre-pregnancy optimal concentration is associated with an increased risk.

 

(4) Non-adherence to AED medication and alterations in AED clearance.

 

(5) C.

 

 

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