Kinderwunsch und Schwangerschaft bei Frauen mit Epilepsie

Zusammenfassung

Die Beratung und Behandlung von Frauen mit Epilepsie und Kinderwunsch umfasst einige besondere Aspekte. Der klinische Alltag zeigt, dass nur eine Minderheit solcher Patientinnen über zentrale Themen wie Interaktion von Antiepileptika mit oralen Kontrazeptiva, Teratogenität der Medikation, Folsäureprophylaxe, Monotherapie in der niedrigst möglichen Dosierung, Stillen des Kindes und andere Besonderheiten im Schwangerschaftsverlauf aufgeklärt ist. Bei frühzeitiger Planung und Beachtung der wichtigsten Gesichtspunkte der Behandlung verläuft die Mehrzahl der Schwangerschaften von Epilepsiepatientinnen günstig. Die vorliegende Arbeit gibt aus klinischer Sicht einen Überblick über die aktuellen Fakten, die für eine rationale Therapie von epilepsiekranken Frauen mit Kinderwunsch notwendig sind.

Abstract

There are many important health issues for women with epilepsy, in particular for women of childbearing age. Recent surveys have shown that only a minority of such patients received information on important issues concerning pregnancy. Pre-pregnancy counselling should include information on interactions of antiepileptic drugs (AEDs) and oral contraceptives, risk of teratogenicity, use of folic acid, the importance of monotherapy with the lowest effective dosage of an AED, and the safety of breast feeding as well as other special aspects of epilepsy and pregnancy. Planned pregnancy and counselling before conception is crucial. With a multidisciplinary approach the majority of pregnancies will have a favourable outcome. The article addresses these issues and describes practical considerations for the counselling of women with epilepsy who are planning pregnancy.

Schlüsselwörter

Epilepsie - Schwangerschaft - Therapie - Antiepileptika - Teratogenität - Stillen

Key words

Epilepsy - pregnancy - therapy - antiepileptic drugs - teratogenicity - breast feeding

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