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[Psychiatric and nervous disorders].

K Hara1

  • 1Department of Perinato-Gynecology, Kagawa Medical School.

Nihon Sanka Fujinka Gakkai Zasshi
|August 1, 1990
PubMed
Summary
This summary is machine-generated.

Managing epilepsy and schizophrenia during pregnancy requires careful consideration of medication risks and benefits. Continued anticonvulsant therapy is crucial for epilepsy, while antipsychotics are generally considered safe for schizophrenia in pregnancy.

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Area of Science:

  • Obstetrics and Gynecology
  • Neurology
  • Psychiatry

Context:

  • Increased incidence of treating pregnant patients with psychiatric and nervous disorders.
  • Historical reluctance to treat due to prejudice and teratogenicity concerns.
  • Improved social acceptance and human rights awareness driving treatment.

Purpose:

  • To discuss the management of pregnancy, delivery, and the neonatal period for women with epilepsy and schizophrenia.
  • To highlight the importance of continued anticonvulsant therapy during pregnancy for epilepsy.
  • To address the safety of antipsychotic medications during pregnancy for schizophrenia.

Summary:

  • Epilepsy affects 0.5% of pregnancies; pregnancy has minimal impact on epilepsy. Anticonvulsant therapy (e.g., phenobarbital, phenytoin) should continue due to higher risks of fetal brain damage from untreated seizures. Trimethadione is contraindicated due to teratogenicity. Regular drug monitoring and postpartum vitamin K assessment are vital. Breastfeeding is permissible, but neonatal withdrawal syndrome must be monitored.

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  • Pregnancy does not significantly affect schizophrenia. Antipsychotic medications like chlorpromazine and haloperidol are considered to have negative teratogenicity in humans, though they may suppress fetal central nervous system function.
  • Impact:

    • Provides guidance on managing common neurological and psychiatric conditions during pregnancy.
    • Emphasizes risk-benefit assessment for medication use in pregnant patients.
    • Aims to reduce adverse fetal and neonatal outcomes associated with untreated maternal disorders.