Epilepsija i trudnoća

master's thesis

• Title (english): Epilepsy and pregnancy
• Author: Dorian Stranić
• Mentor: Vesna Elveđi Gašparović (mentor)
• Committee member: Lana Škrgatić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Vesna Elveđi Gašparović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Epilepsija je najčešća kronična neurološka bolest koja zahvaća više od 50 milijuna ljudi u svijetu. U Hrvatskoj od epilepsije boluje oko 40 tisuća ljudi. Epilepsija u trudnoći predstavlja poseban problem. Sama bolest može štetno djelovati na majku i na fetus, a i korištenje antiepileptičnih lijekova u trudnoći se povezuje sa rizičnijim trudnoćama, povećanim rizikom za kongenitalne malformacije i lošijim perinatalnim ishodima. Zbog toga je nužan multidisciplinaran pristup u praćenju ovih pacijentica. U ovom opservacijskom retrospektivnom istraživanju promatrali smo 53 trudnoće žena koje su tijekom trudnoće koristile antiepileptičku terapiju i ishode njihovih trudnoća, opstetričke komplikacije i perinatalne ishode. Cilj je istraživanja bio odrediti ima li razlika u skupini žena na monoterapiji u odnosu na skupinu na politerapiji. Na monoterapiji je bilo 60.38%, a na politerapiji 39.62% ispitanica. Primijećena je nešto veća učestalost poroda elektivnim carskim rezom (28.57% nasuprot 15.62%) kao i epileptičnih napadaja tijekom trudnoće (33.3% nasuprot 25%) u skupini na politerapiji. Tijekom trajanja studije nije došlo do intrauterine smrti fetusa niti do poroda djeteta s kongenitalnim malformacijama. Pokazalo se da je dobra kontrola epilepsije u godini prije začeća dobar pokazatelj izostanka epileptičnih napadaja tijekom trudnoće. Iz tog je razloga kod žena s epilepsijom generativne dobi planiranje trudnoće od izuzetne važnosti, kako bi se bolest na vrijeme dovela pod kontrolu, a terapija korigirala da kontrola bude postignuta minimalnim brojem lijekova i njihovih doza.

Abstract (english)

Epilepsy is the most common chronic neurological condition, affecting more than 50 million people worldwide. In Croatia, around 40 thousand people are living with epilepsy. Epilepsy in pregnancy poses a special problem. The disease itself can harm both the mother and the fetus and, additionally, the use of antiepileptic drugs during pregnancy is associated with higher risk pregnancies, adverse perinatal outcomes and higher risk of congenital malformations. Because of that, a multidisciplinary approach is essential in the monitoring of these patients. In this opservational retrospective study, we observed 53 pregnancies from women on antiepileptic therapy and the outcomes of their pregnancies, as well as opstetrical complications and perinatal outcomes. The main goal of this study was to determine the differences between the group of women on monotherapy as opposed to the group on polytherapy. 60.38% of women were on monotherapy and 39.62% were on polytherapy. A slightly higher incidences of elective cesarean section (28.57% vs. 15.62%) and epileptic seizures during pregnancy (33.3% nasuprot 25%) were observed in the group on polytherapy. There were no intrauterine fetal death nor children born with congenital malformations during the study. It was shown that the incidence of seizures in the year preceeding conception was a good indicator of the incidence of seizures during pregnancy. For that reason, planning for pregnancy in women with epilepsy of generative age is of great importance, so the patient can put the disease under control with the lowest number and dose of antiepileptic drugs.

• Keywords: epilepsija; trudnoća; perinatalni ishodi
• Keywords (english): epilepsy; pregnancy; perinatal outcomes
• Language: croatian
• URN:NBN: urn:nbn:hr:105:386046
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-24 13:36:40