Browsing by Author "Sindhu, K."

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    Maternal and obstetric outcome of women with epilepsy
    (SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 2009)
    Medical professionals and public are concerned about the complications of pregnancy and delivery in women with epilepsy (WWE).Purpose: Our aim was to prospectively ascertain Occurrence of these complications in a cohort of WWE enrolled in a pregnancy registry.Methods: All complications during pregnancy, delivery and first 48 h Of Postpartum period were recorded according to the registry protocol. This data were compared with similar statistics (for women without epilepsy) from a large teaching hospital.Results: Between April 1998 and March 2005, there were 643 completed pregnancies in this registry. (Mean age 25.7 +/- 4.43 years; generalized epilepsy 46%; localization related epilepsy 54%: primigravida 53%.) Their complications are compared with those of 18,272 pregnancies managed in the teaching hospital (in parentheses). Spontaneous abortions 4.2% (2.38%); medical termination of pregnancies 2.64% (7.71%); anemia 0,62% (0.22%); gestational diabetes 1.56% (3.09%); pregnancy induced hypertension 3.89% (6.45%): antepartum hemorrhage 0.93% (1.64%); preterm labor 1.87% (6.12%); obstructed labor 0.62% (3%): cesarean section 33.4% (29.5%): assisted delivery 2.8% (2.68%); postpartum hemorrhage 0.31% (0.64%): peripartum seizures 1.4% (0.04%); intrauterine death 1.56% (2.2%); fibroid uterus or ovarian cyst 2.33% (0.53%): other medical illness 2.5% (2.15%); TORCH infection 0.31% (0.01%); birth weight <2.0 kg 4.19% (7.66%).Conclusions: There was no significant increase in the risk of complications of pregnancy or delivery except for spontaneous abortions, anemia, ovarian cyst, fibroid uterus, and seizures in the peripartum period which were more frequent in WWE. Frequency of cesarean section is not increased in WWE. There is no undue risk to pregnancy and childbirth in most WWE. (c) 2008 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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    Motor and mental development of infants exposed to antiepileptic drugs in utero
    (EPILEPSY & BEHAVIOR, 2008)
    We prospectively evaluated the mental (MeDQ) and motor (MoDQ) developmental quotients of 395 (67.5% of the eligible) infants of mothers with epilepsy (IME) (mean age: 15 months) enrolled in the Kerala Registry of Epilepsy and Pregnancy between 1998 and 2004. The same developmental pediatricians, blinded to antiepileptic drug (AED) exposure, evaluated the children using the Indian adaptation of the Bayley Scale of Infant Development: Their mean MeDQ was 89.1 +/- 29.9 and mean MoDQ was 90.7 +/- 26.9. The MeDQ and MoDQ were impaired (< 84) for 150 (37.6%) and 133 (33.5%) IME, respectively. Maternal age, type of epilepsy, seizure frequency, or use of folic acid did not correlate with the mean MeDQ or MoDQ. Maternal education was significantly correlated with the MoDQ, but not with the MeDQ, of the infants. Infants not exposed to AEDs (n = 32) had a higher MeDQ (mean: 92.3, 95% CI: 81.4-103.2) and MoDQ (mean 94.7; 95% CI 84.9-104.5) than those exposed to AEDs (MeDQ-mean: 88.6, 95% CI: 85.5-91.6; MoDQ-mean: 90.0, 95% CI: 87.3-92.8). Those exposed to polytherapy had significantly lower developmental quotients than those exposed to monotherapy. Cumulative AED scores during pregnancy had an inverse relationship with developmental quotients. On multiple regression analysis, polytherapy was a stronger predictor of lower developmental quotients than dosage. Compared with carbamazepine monotherapy, valproate monotherapy was associated with significantly lower MeDQ and MoDQ in IME (93.1 and 95 vs 86.9 and 86.1), but the differences between other AEDs were not significant for IME exposed to valproate monotherapy. A limitation of the study is that the influence of maternal intelligence on developmental quotients was not evaluated. (c) 2008 Elsevier Inc. All rights reserved.