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Abstract Details

Is Pre-conceptional counselling for Women with Epilepsy (WWE) beneficial: Experience from Kerala Registry of Pregnancy and Epilepsy, India
Epilepsy/Clinical Neurophysiology (EEG)
P2 - Poster Session 2 (5:30 PM-6:30 PM)
6-004
To determine the effectiveness of Pre-conceptional care (PCC) and determinant of seeking PCC in women with epilepsy (WWE)
Birth defect and seizure worsening during pregnancy are major concerns for WWE. Pre-conceptional care offers an opportunity to address these issues, optimize therapy and prescribe folic acid
All primigravida enrolled in this registry in pre-conceptional stage (PCC group) or first trimesters of pregnancy (PRG group) were included. Socio-economic data, Anti-epileptic drugs (AED) and folic acid therapy during pregnancy, seizure, pregnancy and fetal outcome of the two groups were compared to study the effectiveness of PCC
There were 320 (30.4%) in PCC group and 732 in PRG group. PCC group had significantly higher education (58.8%, p=.003) and better employment (22.1%, p<.001). The two groups were comparable for epilepsy classification, history of maternal birth defects and family history of epilepsy. A higher proportion of WWE in PRG group were on Phenobarbitone (20.2%, p<.001). Valporate use was significantly higher in PCC group (28.4%, p=.025). Within monotherapy group, use of Levetiracetam (10.8%, p=.017) in PCC group and Carbamazepine (39.1%, p=.04) in PRG group was significantly high. Folic acid usage in pre-pregnancy month (87.5%, p<.001) or first trimester (96.3%, p<.001) was significantly higher in PCC group. Seizure freedom during pregnancy was more in PCC group (62.8%, p=.005) than PRG group (54%). Early fetal loss was better captured in PCC (p=.009) compared to PRG. There was no difference in malformation rate between PCC (7.2%) and PRG group (6.1%, p=.306).
PCC improved the pregnancy/first trimester folic acid usage and reduced seizure risk during pregnancy but did not influence the fetal malformation risk. 
Authors/Disclosures

PRESENTER
No disclosure on file
No disclosure on file
No disclosure on file
Sanjeev V. Thomas, MD, FÂé¶¹´«Ã½Ó³»­ (Institute for Communicative and Cognitive Neurosciences) Dr. Thomas has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley India. The institution of Dr. Thomas has received research support from Government of India.