Maternal Mortality in Women with Epilepsy

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Public Health

Background:

• Epilepsy affects approximately 10,000 women of childbearing potential in Ireland.
• Maternal mortality in women with epilepsy is a significant public health concern.
• Optimal care pathways are crucial for managing epilepsy during pregnancy.

Purpose of the Study:

• To determine the maternal mortality rate for women with epilepsy attending the Rotunda Hospital Epilepsy Clinic from 2004 to 2013.
• To identify factors contributing to maternal deaths in this population.
• To advocate for improved care strategies for pregnant women with epilepsy.

Main Methods:

• Retrospective analysis of maternal deaths among women with epilepsy at a specific epilepsy clinic.
• Review of case notes and contributing factors for maternal deaths.
• Calculation of maternal mortality rate.

Main Results:

• Three maternal deaths occurred in women with epilepsy during the study period (2004-2013).
• This represents a maternal mortality rate of 0.8% for this cohort.
• Concerns identified include fetal risks from Anti-Epileptic Drugs (AEDs), limited pre-pregnancy neurology access, and inconsistent healthcare advice.

Conclusions:

• The maternal mortality rate for women with epilepsy at the Rotunda Hospital Epilepsy Clinic was 0.8% between 2004-2013.
• Key contributing factors included issues with Anti-Epileptic Drug (AED) management, access to specialist neurological care, and fragmented healthcare advice.
• Implementing a nationally agreed care plan for women with epilepsy is recommended to improve care quality and potentially reduce maternal mortality.