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Seizure. 2017 Aug;50:67-72. doi: 10.1016/j.seizure.2017.05.004. Epub 2017 Jun 1.

Epilepsy and Pregnancy: For healthy pregnancies and happy outcomes. Suggestions for service improvements from the Multispecialty UK Epilepsy Mortality Group.

Author information

1
School of Medicine, University of Glasgow, G12 8QQ, United Kingdom. Electronic address: Johnpaul.leach@ggc.scot.nhs.uk.
2
The Alan Richens Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, CF14 4XW, United Kingdom. Electronic address: SmithPE@cf.ac.uk.
3
Department of Neurology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, United Kingdom. Electronic address: john.craig@belfasttrust.hscni.net.
4
Regional Complex Epilepsy Service, The Barberry, 25 Vincent Drive, Birmingham, B15 2FG, United Kingdom. Electronic address: manny.bagary@bsmhft.nhs.uk.
5
Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, S2 1JF, United Kingdom.
6
Department of Clinical Neurosciences, Western General Hospital Edinburgh, EH42XU, United Kingdom. Electronic address: susan.duncan4@nhs.net.
7
Royal London Hospital,Whitechapel Road, London, E1 1BB, United Kingdom. Electronic address: andrew.kelso@bartshealth.nhs.uk.
8
Department of Neurology, Liverpool University, Walton Centre for Neurology and Neurosurgery, Liverpool L9 7LJ, United Kingdom. Electronic address: a.g.marson@liv.ac.uk.
9
University Hospital Birmingham, The new Queen Elizabeth Hospital Birmingham, Birmingham, B15 2WB, United Kingdom. Electronic address: dougall.mccorry@uhb.nhs.uk.
10
Department of Neurology, King's College Hospital, London, United Kingdom. Electronic address: lina.nashef@nhs.net.
11
Women's health directorate, St Thomas hospital, London, SE17EH, United Kingdom. Electronic address: Catherine.Nelson-Piercy@gstt.nhs.uk.
12
Ninewells Hospital, Dundee DD1 9SY, United Kingdom. Electronic address: rnorthridge@nhs.net.
13
Department of Neurology, Brunel Building, Level 2, Gate 3, Southmead Hospital, Bristol, BS10 5NB, United Kingdom. Electronic address: kasia.sieradzan@nbt.nhs.uk.
14
Maternal and Perinatal Health Women's Health Research Unit, The Blizard Institute Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom. Electronic address: s.thangaratinam@qmul.ac.uk.
15
UCL Institute of Neurology, Queen Square, WC1N 3BG, United Kingdom. Electronic address: m.walker@ucl.ac.uk.
16
The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, United Kingdom. Electronic address: janine.winterbottom@thewaltoncentre.nhs.uk.
17
Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, S2 1JF, United Kingdom. Electronic address: m.reuber@sheffield.ac.uk.

Abstract

Between 2009 and 2012 there were 26 epilepsy-related deaths in the UK of women who were pregnant or in the first post-partum year. The number of pregnancy-related deaths in women with epilepsy (WWE) has been increasing. Expert assessment suggests that most epilepsy-related deaths in pregnancy were preventable and attributable to poor seizure control. While prevention of seizures during pregnancy is important, a balance must be struck between seizure control and the teratogenic potential of antiepileptic drugs (AEDs). A range of professional guidance on the management of epilepsy in pregnancy has previously been issued, but little attention has been paid to how optimal care can be delivered to WWE by a range of healthcare professionals. We summarise the findings of a multidisciplinary meeting with representation from a wide group of professional bodies. This focussed on the implementation of optimal pregnancy epilepsy care aiming to reduce mortality of epilepsy in mothers and reduce morbidity in babies exposed to AEDs in utero. We identify in particular -What stage to intervene - Golden Moments of opportunities for improving outcomes -Which Key Groups have a role in making change -When - 2020 vision of what these improvements aim to achieve. -How to monitor the success in this field We believe that the service improvement ideas developed for the UK may provide a template for similar initiatives in other countries.

KEYWORDS:

SUDEP; epilepsy; mortality; pregnancy

PMID:
28641176
DOI:
10.1016/j.seizure.2017.05.004
[Indexed for MEDLINE]
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