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Wed, 2/8/2012

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Checklist for Discussions With Your Doctor

pregnant womanPrint out this handy checklist (PDF)

There are many topics that relate to the care of women with epilepsy.

To help you be sure to discuss these topics with your doctor, here is a checklist, divided into sections appropriate to different life stages, which pre-teens, teens, young adult women and older women can use as a guide.

This checklist is meant to serve as a reminder of topics you may want to talk with your doctor about. Background medical information can be found in this Women’s Section as well as at (http://professionals.epilepsy.com/page/specpop_women.html). You can click on the PDF version and print it out to take with you to the doctor’s office.

This discussion checklist was developed by the Epilepsy Therapy Project to help women with epilepsy.

FOR ALL WOMEN, ADOLESCENTS, & PRE-TEENS DURING REPRODUCTIVE YEARS

Relationship between hormones & epilepsy (overview)
Possible menstrual cycle-related influence on seizure (catamenial epilepsy)
Impact of epilepsy on sexual & on reproductive issues
Relationship of epilepsy to fertility
Relation of some seizure medications (AEDs) to sexual desire and fertility
Women with epilepsy CAN become pregnant with or without AEDs; importance of careful pregnancy planning including folate supplementation
Need for effective & consistent form of birth control to avoid unplanned pregnancy
Effective contraception choices (interactions between hormonal contraception & certain AEDs; possible contraceptive failure and need to consider barrier method for added protection)
Other forms of contraception (patch, IUD, Depo Provera®)
Need to inform neurologist if contraception is discontinued
Need for calcium supplementation and vitamin D for bone health

WOMEN PLANNING TO CONCEIVE

Healthy pregnancies & healthy babies are the goal
Need for optimum seizure control
All risks (women not taking AEDs also have risks)
Risks to the baby from AEDs must be balanced with risk of seizures to baby & mother
Ways to reduce risks to mother & baby (eg,AED choices; folate supplementation)
Appropriate AED medication/need to optimize before pregnancy; importance of NOT making any changes without neurology consultation (maintaining good compliance)
Identify an obstetrician comfortable with treating a woman with epilepsy
Need for folate supplementation (especially if mother is taking any enzyme-inducing drug)
How pregnancy can affect seizure frequency & severity
Fertility treatments & possible effects on AED levels & seizure susceptibility

PREGNANT WOMEN

Consultation with patient’s obstetrician
Possible birth defects associated with AEDs
Possible changes in AED therapy (only in consultation with neurologist)
For patients requiring multiple AEDs for seizure control, discussion of choices, risks, & need for close monitoring of AED dose & blood level
Vitamin K recommendations for mother before delivery & for baby
Need to bring AEDs to the hospital during labor and to take regular doses
AED dose adjustment following delivery and post-partum follow-up
Breastfeeding/safety for the newborn
Newborn appointment for neurologist evaluation (age 4-6 wks)
Parenting issues to maximize safety for the newborn including minimizing mother’s fatigue to avoid seizure exacerbation & home safety preparations
Have ultrasound first and second trimester

WOMEN BEYOND CHILDBEARING YEARS

Bone health & need for calcium supplementation & bone density monitoring; seizure control to prevent falls
Peri-menopause effects on seizures/AEDs
Menopause/hormone replacement issues; enzyme-inducing effects of hormones on AEDs

Welcome to the Wiki. This space is created for epilepsy.com members to share their own experiences and expertise to help refine and expand the discussion around important topics.

No members have yet contributed to this topic. If you are not yet an epilepsy.com member, register today to get started on this Wiki topic and the many other advantages of being a member. If you are a member and wish to be the first to edit this Wiki topic, please make sure to login, then click on the orange "Start Wiki" button at the top of this page. Or, learn more about Wikis.



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