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目的探讨妊娠合并癫的风险以及适当的处理。方法回顾性分析我院1984年至2004年妊娠合并癫15例孕妇的病史,记录其年龄、产次、孕周、癫类型以及孕期发作情况、孕期的处理、分娩时情况、新生儿的情况等。结果妊娠合并癫的发生率0.06%。年龄20~29岁6例(40%),30~36岁9例(60%)。初产妇14例,经产妇1例。<37孕周1例,>37孕周14例。66.7%的患者在20岁以前发病,33.3%的患者20岁以后发病。孕期发作频率增加者5例(33.3%),孕期发作频率减少者1例(6.7%),无变化者9例(60%)(7例患者孕期无发作)。单药治疗的10例(66.7%);多药治疗的4例(26.7%);未治疗的1例(6.6%)。新生儿Apgar评分均为10分,并且没有发现一例畸形。产后2例母乳喂养。结论患有癫的妇女建议孕前咨询。指导方针为孕前优化抗癫药物,稳定症状并加服叶酸。建议孕期密切监测血药浓度,及时调整用量。
Objective To explore the risk of pregnancy complicated with epilepsy and its proper treatment. Methods The clinical data of 15 pregnant women with epilepsy during pregnancy from 1984 to 2004 were retrospectively analyzed. The age, birth time, gestational age, epilepsy type, seizure status during pregnancy, pregnancy treatment, Situation and so on. Results The incidence of pregnancy complicated with epilepsy was 0.06%. Six cases (40%) were aged 20-29 years and 9 cases (60%) were 30-36 years old. 14 cases of primipara, maternal 1 case. <37 gestational weeks in 1 case,> 37 gestational weeks in 14 cases. 66.7% of patients before the age of 20 onset, 33.3% of patients after the onset of 20 years of age. There were 5 cases (33.3%) with increased seizure frequency in pregnancy, 1 case (6.7%) with less seizure frequency in pregnancy and 9 cases (60%) with no change (7 cases without seizure during pregnancy). Ten patients (66.7%) treated with monotherapy; four patients (26.7%) treated with multi-drug therapy; and one untreated patients (6.6%). Neonatal Apgar scores were 10 points, and did not find a deformity. Postpartum 2 cases of breastfeeding. Conclusion Women with epilepsy are advised to consult before pregnancy. Guidelines for the optimization of pre-pregnancy anti-epileptic drugs, stable symptoms and add folic acid. It is recommended to closely monitor blood concentration during pregnancy, timely adjustment of dosage.