HEALTH OF WOMAN. 2017.8(124):61–64; doi 10.15574/HW.2017.124.61  

Мелікова Шахла Ягуб гизи
Азербайджанський Медичний Університет, м Баку

Епілепсія є одним з найбільш поширених серйозних неврологічних захворювань. Вивчено безліч публікацій, що стосуються взає-мовпливу епілепсії і вагітності. Жінки з епілепсією переживають низку фізичних і соціальних проблем, пов’язаних з акушерським ризиком, ризиком нападів під час вагітності. Генералізовані епілептичні напади можуть чинити пряму пошкоджувальну дію на плід, хоча немає переконливих даних на користь достовірного підвищення частоти розвитку ускладнень під час вагітності у жінок з епілепсією. Антенатальний вплив протиепілептичних препаратів, особливо у високій дозі і в режимі політерапії, збільшує ризик розвитку вроджених мальформацій. Існують побоювання, пов’язані з впливом протиепілептичних препаратів на немовлят під час грудного вигодовування. Однак ризик ускладнень, пов’язаних як із самим захворюванням, так і впливом протиепілептичних препаратів на плід, може бути знижений за умови ретельного спільного спостереження неврологом-епілептологом та акушером-гінекологом.
Ключові слова: вагітність, антиепілептичні препарати, епілепсія, монотерапія, політерапія.

Література:

1. Карлов В.А. Эпилепсия у детей и взрослых женщин и мужчин // Руководство для врачей. – М.:ОАО « Издательство Медицина», 2010. – 720 с.

2. Магалов Ш.И.Эпилепсия. – 2014. – 160 с.

3. Abe K., Hamada H., Yamada T., Obata-Yasuoka M., Minakami H., Yoshikawa H. Impact of planning of pregnancy in women with epilepsy on seizure control during pregnancy and on maternal and neonatal outcomes // Seizure 2014; 23: 2: 112–116. https://doi.org/10.1016/j.seizure.2013.10.003; PMid:24183922

4. Adab N, Ayres J, Baker G, et al. The longer term outcomes of children born to mothers with epilepsy // J Neurol Neurosurg Psychiatry 2004;75:1575–1583. https://doi.org/10.1136/jnnp.2003.029132; PMid:15491979 PMCid:PMC1738809

5. Aguglia U, Barboni G, Battino D, Cavazzuti GB, Citernesi A, Corosu R, Guzzetta FM, Iannetti P, Mamoli D, Patella A, Pavone L, Perucca E et al. Italian consensus conference on epilepsy and pregnancy, labor and puerperium // Epilepsia. 2009 Jan; 50 Suppl 1:7–23. https://doi.org/10.1111/j.1528-1167.2008.01964.x; PMid:19125842

6. Battino D, Tomson T, Bonizzoni E, et al. Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry // Epilepsia. 2013; 54(9): 1621–1627. https://doi.org/10.1111/epi.12302; PMid:23848605

7. Borthen I, Eide MG et al.Delivery outcome of women with epilepsy: a population-based cohort study // An International Journal of Obstetrics and Gynaecology.2010, p.1537–1543.

8. Borthen I, Eide MG, Daltveit AK, Gilhus NE.Obstetric outcome in women with epilepsy: a hospital-based, retrospective study // BJOG. 2011 Jul;118(8):956–65. https://doi.org/10.1111/j.1471-0528.2011.03004.x; PMid:21557799

9. Cagnetti C, Lattanzi S, Foschi N, Provinciali L, Silvestrini M. Seizure course during pregnancy in catamenial epilepsy // Neurology. 2014; 83(4): 339–344. https://doi.org/10.1212/WNL.0000000000000619; PMid:24944265

10. Christensen J, Sabers A, Sidenius P. Oxcarbazepine concentrationsduring pregnancy: a retrospective study in patients with epilepsy // Neurology 2006, 67:1497–1499. https://doi.org/10.1212/01.wnl.0000240047.11166.0e; PMid:17060586

11. Crawford P and Hudson S. Understanding the information needs of women with epilepsy at different life stages: results of the ‘Ideal World’ survey // Seizure 2003; 12: 502–7. https://doi.org/10.1016/S1059-1311(03)00085-2

12. Crawford P. CPD-education and self-assessment: epilepsy and pregnancy // Seizure. –2001. – № 10. – P. 212–219. https://doi.org/10.1053/seiz.2001.0562; PMid:11437622

13. De Haan GJ, Edelbroek P, Segers J, Engelsman M, Lindhout D, Devile-Notschaele M, Augustijn P. Gestation-induced changes inlamotrigine pharmacokinetics: a monotherapy study // Neurology 2004; 63:571–573. https://doi.org/10.1212/01.WNL.0000133213.10244.FD; PMid:15304599

14. Edey S, Moran N, Nashef L. SUDEP and epilepsy-related mortality in pregnancy // Epilepsia 2014;55(7):72–274. https://doi.org/10.1111/epi.12621; PMid:24754364

15. EURAP Study.Seizure control and treatment in pregnancy: Observations from the EURAP Epilepsy Pregnancy Registry // Neurology 2006, 66: 354–360.

16. Harden C.L. Antiepileptic drug teratogenesis: what are the risks for congenital malformations and adverse cognitive outcomes? // Int Rev Neurobiol. – 2008. – V. 83. – P. 205–13. https://doi.org/10.1016/S0074-7742(08)00011-1

17. Harden C.L., Meador K.J., Pennell P.B. Management issues for women with epilepsy – Focus on pregnancy (an evidencebased review): II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society // Epilepsia 2009;50: 1237–1246. https://doi.org/10.1111/j.1528-1167.2009.02129.x; PMid:19507301

18. Harden C.L., Hopp J., Ting T.Y., Pennell P.B., French J.A., Allen Hauser W. Practice parameter update: management issues for women with epilepsy – focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency. Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society // Neurology 73: 2009; 126–132. https://doi.org/10.1212/WNL.0b013e3181a6b2f8; https://doi.org/10.1212/WNL.0b013e3181a6b325; https://doi.org/10.1212/WNL.0b013e3181a6b312

19. Holmes L.B., Harvey E.A., Coull B.A. et al. The teratogenicity of anticonvulsant drugs // N Engl J Med 2001; 344: 1132–1138. https://doi.org/10.1056/NEJM200104123441504; PMid:11297704

20. Hosie A.M., Wilkins M.E., Silva H.M., Smart T.G. Endogenous neuro-steroids regulate GABA-A receptors through two discrete transmembrane site // Nature, 2006, v. 444 (7118), pp. 486–489. https://doi.org/10.1038/nature05324; PMid:17108970

21. Hvas CL, Henriksen TB, Ostergaard JR, Dam M. Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight // Br J Obstet Gynaecol 2000; 107:896–902. https://doi.org/10.1111/j.1471-0528.2000.tb11089.x

22. Johannessen SI, Helde G, Brodtkorb E.Levetiracetam concentrations in serum and in breast milk at birth and during lactation // Epilepsia 2005 May;46(5):775–7. https://doi.org/10.1111/j.1528-1167.2005.54804.x; PMid:15857447

23. Kaneko S. Epilepsy, pregnancy, and the child // Epilepsia 2000; 41(9): 8–13. https://doi.org/10.1111/j.1528-1157.2000.tb02211.x; PMid:11156513

24. Kaplan P.W. Reproductive health effects and teratogenicity of antiepileptic drugs // Neurology. – 2004. – V. 63 (Suppl 4). – P. 13–23. https://doi.org/10.1212/WNL.63.10_suppl_4.S13

25. Kim J.S., Kondratyev A., Tomita Y., Gale K. Neurodevelopmental impact of antiepileptic drugs and seizures in the immature brain. // Epilepsia. – 2007. – V. 48 (Suppl 5). – P. 19–26. https://doi.org/10.1111/j.1528-1167.2007.01285.x; PMid:17910577

26. La Neve A, Boero G, Francavilla T, Plantamura M, De Agazio G, Specchio LM. Prospective, case-control study on the effect of pregnancy on seizure frequency in women with epilepsy // Neurol Sci. 2015; 36(1): 79–83. https://doi.org/10.1007/s10072-014-1908-0; PMid:25070383

27. Legros B, Bottin P, de Borchgrave V, Delcourt C, de Tourtchaninoff M et al. Therapeutic issues in women with epilepsy // Acta Neurol. Belg., 2003,103 (3): 135–139. PMid:14626692

28. Mani S.K. Signalinq mechanisms in progesterone-neurotransmitter in-teractions // J. Mol. Endocrinol., 2003, v. 30, pp. 127–137. https://doi.org/10.1677/jme.0.0300127; PMid:12683937

29. Morrell MJ. Epilepsy in women // Am Fam Physician. 2002 Oct 15;66(8):1489–94. PMid:12408423

30. Ohman I, Vitols S, Tomson T. Lamotrigine in pregnancy:pharmacokinetics during delivery, in the neonate and during lactation. Epilepsia 2000;41:709–713. https://doi.org/10.1111/j.1528-1157.2000.tb00232.x; PMid:10840403

31. Ornoy A, Zvi N, Arnon J et al. The outcome of pregnancy following topiramate treatment: a study on 52 pregnancies // Reprod Toxicol.2008; 25(3):388–389. https://doi.org/10.1016/j.reprotox.2008.03.001; PMid:18424066

32. Ornoy A. Valproic acid in pregnancy: how much are we endangering the embryo and fetus? // Reprod Toxicol. – 2009.– V. 28 (1). – P. 1–10. https://doi.org/10.1016/j.reprotox.2009.02.014; PMid:19490988

33. Ozdemir O, Sari M, Kurt Aet al. Pregnancy outcome of 149 pregnancies in women with epilepsy: Experience from a tertiary care hospital // Interv Med Appl Sci. 2015 Sep; 7(3): 108–113. https://doi.org/10.1556/1646.7.2015.3.4; PMid:26527567 PMCid:PMC4609022

34. Pennell PB Antiepileptic drug pharmacokinetics during pregnancy and lactation // Neurology. 2003 Sep 1;61(6 Suppl 2):S35–42. https://doi.org/10.1212/WNL.61.6_suppl_2.S35; PMid:14504308

35. Pennell PB.Pregnancy in the woman with epilepsy: maternal and fetal outcomes // SeminNeurol. 2002 Sep;22(3):299–308. https://doi.org/10.1055/s-2002-36649; PMid:12528055

36. Perucca E. Birth defects after prenatal exposure to antiepileptic drugs // Lancet Neurol. – 2005. – V. 4 (11). – P. 781–6. https://doi.org/10.1016/S1474-4422(05)70224-6

37. Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes inlamotrigine plasma concentrations during pregnancy // Epilepsy Res. – 2005;65:185–188. https://doi.org/10.1016/j.eplepsyres.2005.06.004; PMid:16084694

38. Petrenaite V, Sabers A, Hansen-Schwartz J. Seizure deterioration inwomen treated with oxcarbazepine during pregnancy // Epilepsy Res. – 2009;84:245–249. https://doi.org/10.1016/j.eplepsyres.2009.01.011; PMid:19231139

39. Pilo C, Wide K, Winbladh B. Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs // Acta Obstet Gynecol Scand 2006; 85:643–646. https://doi.org/10.1080/00016340600604625; PMid:16752253

40. Reimers A, Helde G, Brathen G, Brodtkorb E. Lamotrigine and itsN2-glucuronide during pregnancy: the significance of renal clearanceand estradiol // Epilepsy Res. –2011; 94:198–205. https://doi.org/10.1016/j.eplepsyres.2011.02.002; PMid:21356585

41. Richmond JR, Krishnamoorthy P, Andermann E, Benjamin A.Epilepsy and pregnancy: an obstetric perspective //Am J Obstet Gynecol. 2004 Feb;190(2):371–9. https://doi.org/10.1016/j.ajog.2003.09.020; PMid:14981376

42. Ried S., Beck-Mannagetta G. Epilepsy, pregnancy and the child // Blackwell Science 1996; 82.

43. Shinnar S, Pellock JM. Update on the epidemiology and prognosis of pediatric epilepsy // J Child Neurol. 2002 Jan;17 Suppl 1:S4–17. https://doi.org/10.1177/08830738020170010201; PMid:11918462

44. Sveberg L., Svalheim S., TaubшllE.The impact of seizures on pregnancy and delivery // Seizure 2015; 28:35–38. https://doi.org/10.1016/j.seizure.2015.02.020; PMid:25746572

45. Thomas S.V., Nair R.R., Jose M., Sarma P.S. Risk of major congenital malformations in the offsprings of women with epilepsy is not related to family history // Epilepsy Res. – 2009. – V. 83 (1). – P. 52–7. https://doi.org/10.1016/j.eplepsyres.2008.09.002; PMid:18977119

46. Thomas SV. Management of epilepsy and pregnancy // J Postgrad Med March 2006 Vol 52 Issue 1;57–64. PMid:16534170

47. Thomas SV, Syam U, Devi JS. Predictors of seizures during pregnancy in women with epilepsy // Epilepsia. 2012 May; 53(5):85–8. https://doi.org/10.1111/j.1528-1167.2012.03439.x; PMid:22429269

48. Tomson T, Battino D. Teratogenic effects of antiepileptic medications // Neurol Clin. 2009;27(4):993–1002. https://doi.org/10.1016/j.ncl.2009.06.006; PMid:19853219

49. Tomson T, Battino D. Teratogenicity of antiepileptic drugs: state of the art // Curr Opin Neurol 2005;18:135–140. https://doi.org/10.1097/01.wco.0000162854.67767.06; PMid:15791143

50. Tomson T, Battino D.Pharmacokine-tics and therapeutic drug monitoring of newer antiepileptic drugs during pregnancy and the puerperium // Clin Pharmacokinet. 2007;46(3):209–19. https://doi.org/10.2165/00003088-200746030-00002; PMid:17328580

51. Tomson T. Teratogenic effects of antiepileptic drugs // Lancet Neurol 2012; 11: 803–813. https://doi.org/10.1016/S1474-4422(12)70103-5

52. Tomson T., Johannessen C, and Battino D.Antiepileptic drug treatment in pregnancy: Changes in drugdisposition and their clinical implications // Epilepsia, 2013; 54(3):405–414. https://doi.org/10.1111/epi.12109; PMid:23360413

53. Tomson T., Battino D., Bonizzoni E., Craig J., Lindhout D., Sabers A., Perucca E., Vajda F.; EURAP study group. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry // Lancet Neurol. – 2011. – V. 10 (7). – P. 609–17. https://doi.org/10.1016/S1474-4422(11)70107-7

54. Tomson Т, Xue H, Battino D.Major congenital malformations in children of women with epilepsy // Seizure 2015; 28; 46–50. https://doi.org/10.1016/j.seizure.2015.02.019; PMid:25777785

55. Vajda F.J.E., Hitchcock A., Graham J. et al. Seizure control in antiepileptic drug- treated pregnancy // Epilepsia. – 2008. – Vol. 49 (1). – P. 172–176. https://doi.org/10.1111/j.1528-1167.2007.01412.x; PMid:18031551

56. Veiby G, Bjшrk M, Engelsen BA, Gilhus NE. Epilepsy and recommendations for breastfeeding.Seizure. 2015 May;28:57–65. https://doi.org/10.1016/j.seizure.2015.02.013; PMid:25837494

57. Vlasov P.N., Karlov V.A., Petrukhin V.A. Эпилепсия и беременность: современная терапевтическая тактика. Неврология, нейропсихиатрия, психосоматика // 2013; 5(1):13–17.

58. Viinikainen K, Heinonen S, Eriksson K, Kalviainan R. Community-based, prospective, controlled study of obstetric and neonatal outcome of 179 pregnancies in women with epilepsy // Epilepsia. – 2006; 47:186–192. https://doi.org/10.1111/j.1528-1167.2006.00386.x; PMid:16417548

59. Yerby M. Quality of life, epilepsy advances, and the evolving role of anticonvulsants in women with epilepsy // Neurology. 2000. – 55(suppl 1). – P. 21–31.