Epilepsy in Pregnancy: Reducing Risks with a Multiprofessional Healthcare Team
Epilepsy is a pre-existing, neurological disease present in 0.3%-0.5% of all pregnancies and is associated with increased risks of morbidity and mortality during the pregnancy continuum. These risks are often determined long before conception. This is because epilepsy and its treatment can impact on: education, employment, safety, menstruation, sexuality, fertility, contraception, pregnancy, breastfeeding, parenting, bone health, mental health, quality of life, driving status and independence. This trajectory and the quality of care received during the epilepsy journey can influence pregnancy presentation and outcome. The extremes can be a woman who has received expert epilepsy care and preconception preparation to ensure the risks were minimized when embarking on a planned pregnancy versus a woman who presents with an unplanned pregnancy having received no counselling, no epilepsy specialist care, prescribed a medication that is high risk to a developing baby whilst having uncontrolled seizures. These extremes highlight the need for maternity healthcare professionals to have awareness about the potential health burden associated with epilepsy, knowledge about seizure presentation and management, information about epilepsy treatments and understanding about potential risks to the women and her developing baby and how to reduce risks during pregnancy through joined-up, holistic, multi-professional healthcare provision.
This presentation was originally presented at our 2021 GOLD Midwifery Conference.
Kim is an advanced clinical practitioner, independent nurse prescriber, registered nurse and registered midwife with additional qualifications in epilepsy, complex pregnancies, child protection, pharmacology, advanced decision making, epidemiology, diagnosis and history taking and research. She is a specialist in antiepileptic drug prescribing management & all aspects of reducing the impact of epilepsy. Since 2000, she has conducted a women with epilepsy service which provides holistic care and treatment support from teenage years to motherhood. In addition, she established and ran for 7 years a thriving community epilepsy specialist nursing service for Southampton and since 2017, a new rapidly expanding secondary care service for Winchester. Kim designed the maternity epilepsy toolkit embedded in the SUDEP (sudden unexpected death in epilepsy) Action professional checklist and focuses professionally and academically on safety and reducing the risk of avoidable adverse outcomes. She is an MBRRACE assessor and represents the Royal College of Midwives on behalf of midwives on the valproate stakeholders committee.
Objective 1: Describe the treatment and optimal preconception management of epilepsy, in preparation of pregnancy.
Objective 2: Discuss risk assessment and prevention strategies to optimize maternal and fetal well-being.
Objective 3: Describe optimal care provision for women with epilepsy in the pregnancy continuum.
Epilepsy is a pre-existing, neurological disease present in 0.3%-0.5% of all pregnancies and is associated with increased risks of morbidity and mortality during the pregnancy continuum. These risks are often determined long before conception. This is because epilepsy and its treatment can impact on: education, employment, safety, menstruation, sexuality, fertility, contraception, pregnancy, breastfeeding, parenting, bone health, mental health, quality of life, driving status and independence. This trajectory and the quality of care received during the epilepsy journey can influence pregnancy presentation and outcome. The extremes can be a woman who has received expert epilepsy care and preconception preparation to ensure the risks were minimized when embarking on a planned pregnancy versus a woman who presents with an unplanned pregnancy having received no counselling, no epilepsy specialist care, prescribed a medication that is high risk to a developing baby whilst having uncontrolled seizures. These extremes highlight the need for maternity healthcare professionals to have awareness about the potential health burden associated with epilepsy, knowledge about seizure presentation and management, information about epilepsy treatments and understanding about potential risks to the women and her developing baby and how to reduce risks during pregnancy through joined-up, holistic, multi-professional healthcare provision.
Accreditation
Midwifery CEUs - MEAC Contact Hours:
This program is accredited through the Midwifery Education & Accreditation Council (MEAC) and is approved for 1 Hour, the equivalent of 0.1 CEU. Please note that 0.1 MEAC Midwifery CEU is equivalent to 1.0 NARM CEUs.
CERPs - Continuing Education Recognition Points Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators. This program is approved for 1 R-CERP. GOLD Conferences have been designated as a Long Term Provider of CERPs by the IBLCE--Approval #CLT114-07
If you have already participated in this program, you are not eligible to receive additional credits for viewing it again. Please send us an email to [email protected] if you have any questions.
Tags / Categories
(IBCLC) Maternal, (IBCLC) Pharmacology and Toxicology, Maternal Illness
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