Epilepsy and pregnancy--a review of 98 pregnancies.

This study presents the clinical and management problems in 81 epileptic patients attending the Queen Victoria Hospital for 98 pregnancies between 1985 and 1988. Epileptic women were found to have a 26.1% risk of seizure deterioration during pregnancy and the single most important factor for predicting seizure prognosis was the severity of epilepsy prepregnancy. There was a significant increase in the complications of vaginal bleeding, preeclampsia, and preterm delivery, compared with a control group of women. Infants of epileptic mothers had an increased incidence of low birth-weight and lower Apgar scores at 5 minutes. The congenital abnormality rate was 14.3% (9 major and 5 minor abnormalities). These results confirm that pregnant epileptic women are a high risk group.