Maternal medicine Flashcards
Which two anti-epileptic drugs do not seem to cause neurodevelopmental delay?
Carbamazepine
Lamotrigine
What is the effect of pregnancy on seizures in women with epilepsy?
Two thirds will not have seizure deterioration in pregnancy
What are the adverse effects of anti-epileptic drugs on the mother during pregnancy?
Depression, anxiety, neuropsychiatric symptoms
How should the foetus be monitored in pregnancy when a woman is taking anti-epileptic drugs?
Serial growth scans should be used to detect SGA babies
What is the optimal timing and mode of birth for women with epilepsy?
The diagnosis of epilepsy is not an indication for Caesarean section or induction of labour
What is the drug of choice for termination of intrapartum seizures?
Benzodiazepines
What advice should be given about opioid use in labour for women with epilepsy?
Pethidine should be used with caution
Diamorphine should be favoured over Pethidine
When is the highest risk time for seizures in pregnancy and how should this be managed?
The postnatal period is the time of highest risk for seizures
Sleep deprivation, stress and pain should be minimised
What advice should be given about breastfeeding for women taking anti-epileptic drugs?
Breastfeeding should be encouraged
The risk of adverse cognitive outcomes is not increased in children exposed to anti-epileptics through breast milk
What should women taking enzyme-inducing anti-epileptic drugs (Carbamazepine, Phenytoin) be advised about contraception?
Efficacy of oral contraceptives, implants and transdermal preparations may be reduced
Copper coil, Mirena and Depot are favoured
What should women taking non-enzyme-inducing anti-epileptic drugs (Valproate, Levetiracetam, Gabapentin) be advised about contraception?
All methods may be offered to these women
Which anti-epileptic drug may have a reduced effect when taking alongside oestrogen-containing contraceptives, possibly resulting in reduced seizure threshold?
Lamotrigine
