Эпилепсия и беременность

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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