nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2024-3-4-11nnp-2271Research ArticleLECTURESЛЕКЦИЯEpilepsy and pregnancyЭпилепсия и беременностьhttps://orcid.org/0000-0001-8321-5864ВласовП. Н.VlasovP. N.

Власов Павел Николаевич.

125006, Москва, ул. Долгоруковская, 4, стр. 7

Pavel N. Vlasov.

4, Dolgorukovskaya St., Build. 7, Moscow 125006

vpn_neuro@mail.ruhttps://orcid.org/0000-0003-1345-1049АжиговаА. М.AzhigovaA. M.

111398, Москва, Кусковская ул., 1А, стр. 4

1A, Kuskovskaya St., Build. 4, Moscow 111398

https://orcid.org/0000-0002-4325-0654ЕфимковаЕ. Б.EfimkovaE. B.

101000, Москва, ул. Покровка, 22а

22a, Pokrovka St., Moscow 101000

https://orcid.org/0000-0003-0460-3047ПетрухинВ. A.PetrukhinV. A.

129110, Москва, ул. Щепкина, 61/2

61/2, Shepkina St., Moscow 129110

Кафедра неврологии Университетской клиники ФГБОУ ВО «Российский университет медицины» Минздрава РоссииРоссияAcademic Department of Neurology of University Clinic of Russian University of Medicine, Ministry of Health of RussiaRussian FederationНеврологическое отделение Университетской клиники ФГБОУ ВО «Российский университет медицины» Минздрава РоссииРоссияDepartment of Neurology of University Clinic of Russian University of Medicine, Ministry of Health of RussiaRussian FederationГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии им. акад. В.И. Краснопольского»РоссияMoscow Regional Research Institute of Obstetrics and Gynecology named after Academician V.I. KrasnopolskyRussian FederationКафедра акушерства и гинекологии факультета усовершенствования врачей ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»РоссияMoscow Regional Research and Clinical Institute named after M.F. VladimirskyRussian Federation202420062024163411Copyright © Vlasov P.N., Azhigova A.M., Efimkova E.B., Petrukhin V.A., 20242024Власов П.Н., Ажигова А.М., Ефимкова Е.Б., Петрухин В.A.Vlasov P.N., Azhigova A.M., Efimkova E.B., Petrukhin V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2271

There are currently about 15 million women of childbearing age worldwide who suffer from epilepsy. Overall, 0.3–0.4% of newborns are born to mothers with epilepsy, and almost half of these women experience recurrent seizures. The article discusses issues related to pregnancy planning, the prognostic impact of seizure frequency, type and course of epilepsy on pregnancy outcomes, and potential risks associated with this condition. Summarized data from the latest recommendations for correction of therapy and data on changes in the pharmacokinetics of antiepileptic drugs during pregnancy are presented. A classification of antiepileptic drugs according to their teratogenic potential and their effect on the development and behaviour of the child is presented. Various approaches to pregnancy management are discussed. In addition, scenarios for pregnancy management in poorly controlled epilepsy and status epilepticus are discussed as well as adjustment of therapy in the postpartum period and measures for the safe care of newborns.

В настоящее время в мире насчитывается около 15 млн женщин детородного возраста, больных эпилепсией. Всего от матерей с эпилепсией рождается 0,3–0,4% новорожденных, причем почти у половины этих женщин наблюдаются повторные приступы. В статье рассматриваются вопросы, связанные с подготовкой к беременности, прогностическим влиянием частоты приступов, типа и течения эпилепсии на исходы беременности, а также потенциальные риски, связанные с этим заболеванием. Приведены сводные данные из последних рекомендаций по коррекции терапии и данные об изменении фармакокинетики противоэпилептических препаратов во время беременности. Представлена классификация противоэпилептических препаратов по тератогенному потенциалу и влиянию на развитие и поведение детей. Обсуждаются различные подходы к ведению беременности. Рассмотрены сценарии ведения беременности при плохо контролируемой эпилепсии и эпилептическом статусе, а также коррекция терапии в послеродовом периоде и меры по безопасному уходу за новорожденными.

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The authors declare that there are no conflicts of interest present.