Ectopic pregnancy as contraceptive failure in patient with epilepsy

Scientific paper - Case study

• Title (croatian): Ektopična trudnoća - kontracepcijska greška u bolesnice s epilepsijom
• Author: Branko Radaković
• Author: Marina Šprem Goldštajn
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Epilepsy is a common neurologic condition which includes many women's health issues. Menstrual disorders, reproductive endocrinological disturbances, ovulatory dysfunction and infertility appear to be relatively frequent in women with epilepsy. Clinical decision making which contraceptive regimen is optimal for an individual woman with epilepsy is one of the most challenging tasks when taking care of women with epilepsy. A higher incidence of breakthrough bleeding and contraceptive failure was determined among women using antiepileptic drugs. There is the increased risk for contraceptive failure with the use of P450 3A4 enzyme-inducing antiepileptic drugs (AEDs) such as phenobarbital, carbamazepine, phenytoin, felbamate, topiramate and oxcarbazepine. Therefore, it is recommended to use noninducing AEDs, or for those who use inducing AEDs, the use of oral hormonal contraceptive pills which contained equal or more than 50 microg of estrogen, or intrauterine devices. The aim of the article is to present woman with epilepsy who was used combined low dose oral contraceptive pills containing 20 microg of ethinyl estradiol which in interaction with carbamazepine resulted with ectopic tubar pregnancy.

Abstract (croatian)

Epilepsija je relativno čest neurološki poremećaj koji bitno utječe na različite aspekte zdravlja žene. Poremećaj menstruacijskog
ciklusa, reprodukcijski endokrinološki poremećaji i neplodnost značajno utječu na kvalitetu života žene s
epilepsijom. Klinička procjena i izbor optimalnog kontracepcijskog protokola u žena s epilepsijom je veliki izazov s
obzirom na česta probojna krvarenja i kontracepcijski neuspjeh koji se javljaju u žena koje koriste antiepileptike i
oralnu hormonsku kontracepciju. S obzirom na povećani rizik kontracepcijskog neuspjeha u žena koje koriste antiepileptike
koji induciraju jetrene mikrosomalne enzime (phenobarbital, karbamazepin, fenitoin, felbamat, topiramat i
okskarbazepin), preporuka je korištenje oralne hormonske kontracepcije koja sadrži 50 ili više mikrograma etinil estradiola,
materničnog uloška ili promjena osnovne terapije epilepsije primjenom nove generacije antiepileptika koji ne
induciraju jetrene mikrosomalne enzime. Cilj ovog rada je prikazati ženu s epilepsijom koja je koristila kombiniranu
niskodozažnu oralnu hormonsku kontracepciju koja sadrži 20 mikrograma etinil estradiola i antiepileptik karbamazepin, što je
rezultiralo kontracepcijskim neuspjehom i ektopičnom tubarnom trudnoćom.

• Keywords (english): Adult; Anticonvulsants / adverse effects; Contraceptives, Oral / administration & dosage; Drug Interactions; Epilepsy / complications; Epilepsy / drug therapy; Female; Humans; Pregnancy; Pregnancy, Ectopic / etiology
• Language: english
• Publication type: Scientific paper - Case study
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 36, no. 4, pp. 1475-1476
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:588264
• Publication: 2012-12
• Document URL: https://hrcak.srce.hr/95025
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 19:44:10