OBJECTIVE: Neurological diseases remain the second most common cause of maternal mortality from indirect causes, according to the last United Kingdom confidential enquiry into maternal death. The maternal mortality rate from epilepsy is reported as 0.61 per 100,000 maternities. The aim of this study was to analyse the trends and causes of maternal death from epilepsy in the UK over the last 30 years. Information on sub-standard care associated with fatalities was also consolidated to inform guidance and clinical care by obstetricians and physicians caring for pregnant women with epilepsy. STUDY DESIGN: A retrospective review of 10 triennial confidential enquiry into maternal death reports (1979-2008) was performed, encompassing 21,514,457 maternities. Late and coincidental deaths were not included in the analyses. RESULTS: Between 1979 and 2008, there were 92 maternal deaths from epilepsy. The proportion of total maternal deaths from epilepsy over 30 years is 3.7% (95% CI 3.0-4.5), which showed an increasing trend. Sudden unexpected death in epilepsy remains the single greatest cause of maternal death from epilepsy followed by aspiration of gastric contents during seizures and drowning during bathing. CONCLUSION: All women with epilepsy should be looked after by specialist combined obstetric and medical or neurological teams in pregnancy to improve maternal and fetal outcomes.
OBJECTIVE:Neurological diseases remain the second most common cause of maternal mortality from indirect causes, according to the last United Kingdom confidential enquiry into maternal death. The maternal mortality rate from epilepsy is reported as 0.61 per 100,000 maternities. The aim of this study was to analyse the trends and causes of maternal death from epilepsy in the UK over the last 30 years. Information on sub-standard care associated with fatalities was also consolidated to inform guidance and clinical care by obstetricians and physicians caring for pregnant women with epilepsy. STUDY DESIGN: A retrospective review of 10 triennial confidential enquiry into maternal death reports (1979-2008) was performed, encompassing 21,514,457 maternities. Late and coincidental deaths were not included in the analyses. RESULTS: Between 1979 and 2008, there were 92 maternal deaths from epilepsy. The proportion of total maternal deaths from epilepsy over 30 years is 3.7% (95% CI 3.0-4.5), which showed an increasing trend. Sudden unexpected death in epilepsy remains the single greatest cause of maternal death from epilepsy followed by aspiration of gastric contents during seizures and drowning during bathing. CONCLUSION: All women with epilepsy should be looked after by specialist combined obstetric and medical or neurological teams in pregnancy to improve maternal and fetal outcomes.
Authors: Roch Cantwell; Thomas Clutton-Brock; Griselda Cooper; Andrew Dawson; James Drife; Debbie Garrod; Ann Harper; Diana Hulbert; Sebastian Lucas; John McClure; Harry Millward-Sadler; James Neilson; Catherine Nelson-Piercy; Jane Norman; Colm O'Herlihy; Margaret Oates; Judy Shakespeare; Michael de Swiet; Catherine Williamson; Valerie Beale; Marian Knight; Christopher Lennox; Alison Miller; Dharmishta Parmar; Jane Rogers; Anna Springett Journal: BJOG Date: 2011-03 Impact factor: 6.531
Authors: P B Pennell; L Peng; D J Newport; J C Ritchie; A Koganti; D K Holley; M Newman; Z N Stowe Journal: Neurology Date: 2007-11-28 Impact factor: 9.910