Women with epilepsy are not getting pregnancy advice

BMJ 1999;318:1374 ( 22 May )

News

Women with epilepsy are not getting pregnancy advice

Vicki Madden , London

Women with epilepsy are not getting the advice they need on issues relating to contraception and pregnancy, according to asurvey of women members of the British Epilepsy Association (Seizure1999;8:135-9).

A total of 1855 women aged 16 or older with epilepsy returned questionnaires sent to 6000 women members of the association.Half of the women, aged between 16 and 55 claimed to have receivedno advice about possible interactions between their antiepilepticdrug treatments and the methods of contraception theyused.

Of the 189 women taking the oral contraceptive pill, only 43%had been given advice about the reduced effectiveness of thepill when it was taken together with enzyme inducing antiepilepticdrugs, and 16%claimed to have received no information atall.

While nearly half (47%) of those surveyed had children and 23%were planning to have children in the future, one third claimedto have received no advice about the effects of epilepsy on theirpregnancy.

The teratogenicity of anti-epileptic medication was discussed with only 15%of those women who planned to have children withinthe next two years. Prepregnancy counselling and the need forfolic acid supplementation and extra monitoring during pregnancywas discussed with only a tiny minority (5%) of thewomen.

Commenting on the findings of the survey, Dr Pamela Crawford, consultant neurologist at York District Hospital, said thatwomen with epilepsy should aim to be taking the lowest possibledose of a single drug that will control their seizures