Manajemen Epilepsi pada Kehamilan
Abstract: Epilepsy is recognized
as the commonest serious neurological disorder in the world. Women with
epilepsy experience several
gender-related physical and social problems. They constitute high obstetric
risk because of reduced fertility, risk of seizures during pregnancy, and complications
of pregnancy. Hormonal and other factors can alter the pharmacokinetics of
antiepileptic drugs during pregnancy and puerperium. Antenatal exposure to
antiepileptic drugs, particularly at higher dosage and in polytherapy,
increases the risk of fetal malformation. Recent reports raise the possibility
of selective developmental language deficits and neurocognitive deficits with
antenatal exposure to antiepileptic drugs. There are concerns regarding the
effect of traces of antiepileptic drugs that pass to the infant during
breast-feeding. The pre conception management is the cornerstone for epilepsy
care in Women with epilepsy. A careful reappraisal of each case should
ascertain the diagnosis, the need for continued antiepileptic drugs therapy,
selection of appropriate antiepileptic drugs, optimization of the dosage, and
prescription of folic acid. During pregnancy, the fetal status needs to be
monitored with estimation of serum a-feto-protein and ultrasound screening for
malformations. The dosage of antiepileptic drugs can be adjusted according to
clinical requirement and blood levels of antiepileptic drugs. Several
institutions recommend oral vitamin K toward the end of pregnancy when
enzymeinducing.
Penulis: Agus Taufiqurrohman,
Damodoro Nuradyo, Harsono Harsono
Kode Jurnal: jpkedokterandd090011
