[HYPERTENSIVE DISORDERS IN PREGNANT WOMAN WITH EPILEPSY]

To determine the frequency and the course of hypertensive disorders in pregnant women with epilepsy (PWWE).

The survey is prospective and covers 206 PWWE during the period 1997-2012 year, monitored and treated in Risk Pregnancy Clinic of University Hospital - Pleven. All the patients (PWWE) are with clinically established etiology and prescription of epilepsy, type of seizures and their frequency. EEG records, ultrasound of fetus and cardiotocograph monitoring were conducted. Eleven of PWWE were with Praeeclampsia - Eclampsia (PE-Ecl).

The frequency of PE-Ecl is 5.33%. Praeeclampsia and Eclampsia were found (monitored) during two consecutive pregnancies in one of the PWWE. Six patients were with severe Praeeclampsia and one of them was with data of HELLP syndrome. There were three cases with Eclampsia. Delivery by surgery was made in 8 cases, (7 patients, but for one of them twice). The other 4 pregnant women with moderate Praeeclampsia got delivery per vias naturales. Epileptic seizures during pregnancy were recorded for 5 of PWWE. One patient was with generalized clonic-tonic seizures and 4 other were with partial seizures. During the period 24 hours after delivery seizures were noted for 4 patients. Six PWWE were without therapy with antiepileptic drugs (AED). Three of them started monotherapy with AED during pregnancy. One other patient with pharmacoresistant symptomatic epilepsy (meningiomas of the brain with two neurosurgical operations) was on polytherapy with 3 AED during the whole pregnancy. The EEG study showed focal activity predominantly occipital, occipito-temporal and parieto-occpital.

The detection of arterial hypertension and proteinuria in PWWE should focus attention on PE-Ecl. The united active clinical monitoring and treatment by a neurologist-epileptologist and obstetrician is the most accurate clinical behavior.