The Polish National Epilepsy Centre for Pregnant Women (OCPK) was opened at the Foundation of Epileptology in 2002 and deals with three major issues:
- A Polish national register of pregnant epileptic women (the centre was created to meet the recommendations of a project realised by the International League Against Epilepsy, creator of the European Register of Antiepileptic Drugs and Pregnancy (EURAP).
- Consultation of pregnant epileptic women. Patients are offered highly professional consultations, free of charge. They can also have an EEG and measure the serum concentration of antiepileptic drugs.
- Education. The Centre conducts cyclic, theme training for medical professionals interested in epilepsy and pregnancy.
The OCPK also conducts research within the EURAP framework. This research focuses on the risk of foetal developmental anomalies in women who take various antiepileptic drugs during pregnancy. Earlier findings were based on insufficiently large samples and therefore cannot be used to make reliable assessments of the risk of pathological pregnancy and foetal development depending on the type of antiepileptic drug. What we know for sure is that the more antiepileptic drugs the patient is taking, the higher the risk. When only one AED is used, 90% of pregnant epileptic women have a chance of giving birth to a healthy baby.
Within a few years, the EURAP program has embraced about 3 000 pregnant women taking various antiepileptic drugs. The statisticians recommend that 6 000 is the number needed to get significant and reliable results and conclusions. A similar program is under way in the United States of America.
Poland has been an active participant of the EURAP program since December 1999 when the Epilepsy and Pregnancy Commission was established at the Polish Society of Epileptology and the Polish Regional Commission was established by the International League Against Epilepsy. The registration protocol is realised in over a dozen neurological centres all over Poland of which the most active are the ones in Warsaw, Katowice, Gdańsk, Lublin, Olsztyn, Sucha Bezkidzka and Białystok (see the list below). Dr Joanna Jędrzejczak, M. D. Ph. D. is Regional Co-ordinator. For more detailed information on how EURAP works see: Epileptologia
i, 2000, 8: 139-151.
The experience which has accumulated from the realisation of the EURAP research procedures to date indicate the need to optimise the mode of operation. To improve the Register's efficiency and encourage a more active approach the Polish National Epilepsy Centre for Women with Epilepsy was opened at the Foundation of Epileptology in 2003.
This move is a practical addition to the symposia on epilepsy and pregnancy which have been organised since 1993.
The OCPK stimulates and monitors research in Poland by:
- promoting the research protocol among interested medical professionals and medical societies;
- distributing the protocol to interested individuals and groups;
- registering participant medical professionals/centres and supplying research materials;
- periodical training of medical professionals who are interested in epilepsy and pregnancy.
The Register is a prospective assessment of the course of pregnancy in epileptic women and it pays particular attention to the risk of major developmental anomalies. Its goals are to recognise the status quo but above all to gather source material which will help to consult women who wish to get pregnant.
Registration is open, prospective, multi-centre and consists of five phases:
- Registration - patient referral no later than the sixteenth week of pregnancy
- Observation - end of trimester I
- Observation - end of trimester II
- Observation - postpartum
- Observation - after the baby's first birthday.
The protocol is purely observational and does not require any modifications of the treatment protocol or the strategy of case management. The doctor in charge makes these decisions and if he/she feels that it is advisable, he/she may seek expert opinion at the OCPK.
Every physician/centre in Poland can participate in the program. Interested doctors should contact their regional co-ordinator (see the list below) or the Polish National Epilepsy Centre for Pregnant Women. They will be entered in the list of participants and will be sent copies of the appropriate questionnaires.
The OCPK can operate thanks to honorary research grants from GlaxoSmithKline and Novartis.
Chief Regional Co-ordinator
Associate Professor Joanna Jędrzejczak, M. D., Ph. D.
||The Foundation of Epileptology,
ul. Wiertnicza 122,
tel. (22) 842-24-92
fax. (22) 642-74-34
||Department of Neurology and Epileptology,
Medical Centre for Postgraduate Education,
ul. Czerniakowska 231,
Monika Kopeć, M. D.
Klinika Neurologii Akademii Medycznej w Białymstoku
Poradnia Neurologiczna SPSK
ul. M. Skłodowskiej- Curie 24a, 15-276 Białystok
tel. (0-85) 746 83 26 (362)
fax 0-85 746 86 08
Lidia Michalak, M. D.
Wojewódzka Przychodnia Zdrowia Psychicznego
i Chorób Układu Nerwowego
ul. Tuwima 25, Gdańsk
tel. (0-58) 520 18 80, 520 18 79
Ewa Motta, M. D., Ph. D.
Samodzielny Publiczny Szpital nr 7
Górnośląskie Centrum Med. Śl. AM
Katedra i Klinika Neurologii Śl. AM
ul. Ziołowa 45/47, 40-635 Katowice
tel/Fax: (0-32) 202 95 92
Barbara Chmielewska, M. D.
Katedra i Klinika Neurologii Akademii Medycznej SPSK Nr 4
Poradnia Neurologiczna SPSK Nr 4
ul. Jaczewskiego 8, 20-950 Lublin
tel/Fax: (0-747 55 72
Barbara Stadnicka-Kossowska, M. D.
Poradnia Diagnostyki i Leczenia Padaczki
ul. Szpitalna 22, 34-200 Sucha Beskidzka
tel. (0-33) 874 36 55 w. 257
Anna Barczewska, M. D.
Wojewódzka Konsultacyjna Poradnia Neurologiczna
ul. Żołnierska 18, 10-561 Olsztyn
tel. (0-89) 538 63 82