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Survey of outcomes in pregnant women with epilepsy A report of a study involving 300 pregnant women who were prepared to be interviewed and a further 100 who were not. Amongst the key findings presented are the following: Only 11% of women were taking appropriate folate supplementation 61% of women had their epilepsy managed by GPs 71% reported ongoing seizures 38% recalled receiving preconception counselling Less than 50% of pregnancies were planned The rate of congenital malformations seen in this study was 5% this included 4 affected babies born to women not taking any antiepileptic drugs ; , which is higher than the expected rate of about 2.4% seen in the general population. BMJ. 2000; 321: 674-5- full text. Recommendations Strongly recommend continuing outpatient rehabilitation services in the setting in which they can most appropriately and effectively be carried out. This is based on medical status, function, social support, and access to care. Discussion In determining where continued rehabilitation should take place after hospital discharge, the following factors must be considered. The discharge plan is developed within the coordinated team. Traditionally, this process is led by the social worker on the team. 1. Can the patient tolerate treatment provided in the outpatient setting? Some patients who are appropriate for discharge, those who still require continued therapy, may not be able to tolerate a full outpatient program. They may be too frail or debilitated to tolerate traveling to an outpatient clinic setting. The distance to be traveled should not be prohibitive, and the patient must be able to safely travel by the available means ie, transfers and sitting balance ; and tolerate the travel, in addition to the therapy sessions. Patients may require inter.

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