Knowledge and practice profile of obstetricians regarding epilepsy in women in Kerala state, India

PURPOSE: To assess the knowledge of obstetricians about concerns of women with epilepsy. MATERIALS AND METHODS: We surveyed 97 obstetricians (teaching hospitals—43, private hospitals—32, and community health centers–21) using knowledge of women's issues and epilepsy (KOWIE) questionnaire II with additional questions. RESULTS: The mean duration of practice of the surveyed obstetricians was 12.4 ± 10.7 years and 94% were female doctors. Most of them were well informed about the teratogenic effects of AEDs (91%), need to continue antiepileptic drugs (AEDs) during pregnancy (95%), and the role of folic acid and vitamin K during pregnancy (95%). They agreed AEDs decrease the efficacy of oral contraception and it was safe for the woman to breast-feed the baby while on AEDs. Only 1/3(rd) of them knew that steroid hormones could alter seizure threshold or that AEDs could predispose to osteomalacia. Fewer doctors knew that WWE could have increased sexual dysfunction (29.9%) or infertility (26.8%). The knowledge did not vary according to years of practice or practice settings. CONCLUSIONS: Obstetricians were well informed about the fetal complications of antenatal AED exposure, but were under informed of other complications such as osteomalacia, sexual dysfunction, and infertility.