Pregnancy and epileptic seizures in the emergency department setting: A retrospective analysis.

BACKGROUND: This study evaluated the clinical features, management, and outcomes of pregnant women with generalized tonic-clonic seizures presenting to the emergency department (ED). The aim was to demonstrate how patients' clinical features contribute to patient management and prognosis. METHODS: In this retrospective study, pregnant women over the age of 18 who presented to the ED with generalized tonic-clonic seizures were included. The patients' demographic characteristics, clinical findings, treatments administered in the ED, and outcomes were recorded. Descriptive statistics, the chi-square tests or Fisher's exact tests for categorical variables and the Mann-Whitney U or t-test for continuous variables were used in the statistical analysis. RESULTS: The study included 48 patients, most of whom were in their third trimester. Thirty-three (69%) patients had a history of epilepsy, and 28 (58.3%) were using antiseizure medications (ASMs). The most commonly used ASM was levetiracetam. Seven (14.6%) patients had suspected eclampsia, and seizure control was achieved in four of them by administering ASMs in addition to magnesium sulfate treatment. Two (4.2%) patients developed status epilepticus (SE). A significant relationship was observed between gestational age and hospitalization (p = 0.005). CONCLUSION: The diagnostic complexity of epileptic seizures in pregnancy complicates treatment choices, and ASM use may also be beneficial in managing eclampsia.