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Abstract

第117巻第11号

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Monitoring and Care of Expectant Mothers with Epilepsy
Masako WATANABE1,2, Masayuki HONDA1,3
1 National Center of Neurology and Psychiatry
2 Shinjuku Neuro Clinic
3 Graduate School of Medicine, The University of Tokyo
Psychiatria et Neurologia Japonica 117: 918-927, 2015

 Women with epilepsy are exposed to social stigma, and they have anxiety and lose self-confidence in their social role as a woman. Psychiatrists, especially female psychiatrists, are able to support them. Important considerations are: 1) Pre-pregnant counseling; Physicians give appropriate advice and guidance. We need to provide the latest information on the teratogenicity of AEDs, and replace them with a safer combination of AEDs BEFORE pregnancy. Folate supplementation is also recommended. 2) Management during pregnancy: Patients are advised to adhere to taking AEDs as instructed, which prevents not only seizures during pregnancy but also reduces the risk of miscarriage and premature delivery. Doses of AED are to be increased after the second trimester. 3) Collaborating with obstetricians at delivery: Obstetricians are also nervous when faced with women with epilepsy. Basically, patients can deliver spontaneously, and the correct way to deal with unexpected seizures during labor should be fully understood. 4) Parental care: women with epilepsy can breastfeed. Physicians advise other family members on how to bottle feed at night to help mothers avoid a lack of sleep due to breastfeeding.
 Childcare is one of the most precious experiences in life. Patients with epilepsy, especially women, have a lower self-esteem; however, once they experience delivery, they act positively and become even-tempered. Physicians should be aware that childcare fosters a profound insight into their lives, allowing them to mature as a person.
 <Authors' abstract>

Keywords:women, epilepsy, pregnancy, delivery, childcare>
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