A Propósito de Um Caso Clínico
Carla Tovim Rodrigues*; Miguel Branco†, Isabel Ferreira*; Paula Estanqueiro†; Teresa Vicente*; Isabel Silva*; Ana Couceiro*; Conceição Ramos‡
Serviços de *Obstetrícia/Ginecologia e ‡Neonatologia da Maternidade Bissaya-Barreto; †Serviço de Pediatria do Hospital Pediátrico de Coimbra.
A epilepsia representa a patologia neurológica mais comum durante a gravidez. Na maioria dos casos decorre sem intercorrências mas o risco obstétrico e de complicações neonatais está aumentado. Os antiepilépticos estão associados a um risco duas a três vezes maior de malformações major. Os autores apresentam o caso clínico de uma grávida com epilepsia desde os 20 anos de idade e de difícil controlo. A primeira gravidez, na qual esteve medicada com valproato de sódio, terminou às 23 semanas de gestação por diagnóstico de espinha bífida. Posteriormente foi medicada em pré-concepcional com carbamazepina e suplementos de ácido fólico. Engravidou após um bom controlo da doença, tendo esta gravidez decorrido sem complicações.
Palavras-chave: gravidez, epilepsia, vigilância pré-natal, anti-epilépticos, defeitos do tubo neural, profilaxia com ácido fólico.
]]> Epilepsy and Pregnancy: What Management?
Epilepsy is the most common neurological disturbance during pregnancy. The vast majority of these pregnancies are uncomplicated, but there are increased obstetric risks and increased adverse neonatal outcomes compared with the general population. Antiepileptic treatment during pregnancy is associated with two to three-fold increase in the rate of major congenital anomalies. The authors present a case report of a pregnant woman with epilepsy since 20 years old, with difficult control of seizures. The first pregnancy, in witch she was treated with valproate, was terminated at 23 weeks’ gestation because the fetus developed a spina bifida. In a pre conceptional consultancy she was treated with carbamazepina and acid folic supplementation. She get pregnant after a good control of the disease, and had a healthy child.
Key-words: pregnancy, epilepsy, prenatal screening,
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Correspondência:
Dr.ª Carla Tovim Rodrigues
]]> Serviço de ObstetríciaMaternidade Bissaya-Barreto
Rua Augusta 3000 Coimbra
e-mail: carlatr1@hotmail.com
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