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clinical practice

Epilepsy in pregnancy: an emergency care context

02 April 2020
Features
02 April 2020
Volume 12 · Issue 4

Abstract

Epilepsy is a heterogeneous neurological condition that manifests clinically in seizure, and diagnosis depends on seizure duration, frequency and characteristics. Seizures can lead to injury and poorly controlled epilepsy can cause sudden death. Women with epilepsy have a small but significant risk of adverse pregnancy outcomes such as antepartum and postpartum haemorrhaging, miscarriage, preterm birth or needing an induced birth or a caesarean section; two-thirds will not experience an increase in the severity or number of seizures during pregnancy. Paramedics should be aware that women with pre-eclampsia and eclampsia may have seizures, and that women may stop taking their anti-epileptic drugs or reduce dosage because of concerns over congenital malformation. Multidisciplinary care is essential for these women.

After completing this module, the paramedic will be able to:

If you would like to send feedback, please email jpp@markallengroup.com

An operational definition of epilepsy is important so that paramedics can best understand their potential role in the emergency care of women with the condition who are pregnant. For the purposes of this article, epilepsy is defined as a heterogeneous neurological condition originating from the brain that results in the clinical manifestation of seizure (Kwan and Brodie, 2010).

The occurrence of seizures can have a huge impact on patients' quality of life, as well on as their physical and emotional wellbeing (Artama et al, 2017).

Status epilepticus is defined as seizure activity of longer than 30 minutes, without consciousness being regained; as yet, there is insufficient evidence to demonstrate that pregnant women diagnosed with epilepsy are more likely to progress to status epilepticus than their non-pregnant counterparts (Kwan and Brodie, 2010).

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