engleski

PROSPECTIVE SURVEILLANCE OF CROATIAN PREGNANT WOMEN UNDER LAMOTRIGINE MONOTHERAPY – ASPECTS OF PRE-PREGNANCY COUNSELING AND DRUG MONITORING

Purpose: Th is is prospective study designed to follow up pregnancies of women with epilepsy treated with lamotrigine (LTG) and their off spring in order to provide additional data of teratogenic risk of LTG and to assess eff ects of preconception counseling and signifi cance of drug monitoring. Method: Th e data obtained from pregnant women included their age, previous abortions, parity, duration and therapy of epilepsy. Th e current pregnancy data included pregnancy planning, periconceptional folic acid intake, frequency of seizures, adjustment of LTG doses and outcome of pregnancy. Adjusted LTG doses after pregnancy were also collected. Results: Six from 23 women had adverse eff ects: 1 elective termination of pregnancy, 1 intrauterine fetal death, 2 spontaneous abortions and 2 preterm deliveries. Th ere were no congenital malformations in the off spring. Th ere was large inter-patient variation during LTG monitoring and in the need for dose adjustment. No maternal toxicity of lamotrigine was observed. Planned pregnancy enabled proper periconceptional folic acid supplementation. Women with pregnancy planning and folic acid intake delivered babies with higher values of birth weight and height. All live-births are prospectively surveyed by Paediatricians and till now no adverse eff ects were noted. Conclusion: Th is survey is 1st phase of an ongoing prospective study including pregnant women with epilepsy treated with all types of AEDs. Th ese data indicate that treatment with LTG during pregnancy might be relatively safe. Pre-pregnancy counseling and individual approach to every woman and monotherapy with minimal eff ective LTG dose with frequent drug monitoring enlarges possibility for successful pregnancy.

antiepileptic drugs (AED); epilepsy; pregnancy; lamotrigine

nije evidentirano