Poster Session 1
Category: Hypertension
Poster Session 1
Daniel J. Martingano, DO, MBA, PhD
Clerkship Director, IRB Chair, Associate Program Director / Division Chair
St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Melody Boafo, MD
OB/GYN Resident
St. John's Episcopal Hospital-South Shore
hackettstown, New Jersey, United States
Andrea Rivera, MD
OB/GYN Resident
Wyckoff Heights Medical Center
Wyckoff Heights Medical Center / Brooklyn, New York, United States
Crystal Awad, DO
OB/GYN Resident
Jamaica Hospital Medical Center
Jamaica Hospital Medical Center / Queens, New York, United States
Marwah Al-Dulaimi, MD (she/her/hers)
OB/GYN Resident
St. John's Episcopal Hospital-South Shore
St. John's Episcopal Hospital-South Shore, New York, United States
Samantha Giler, MS
St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Jaina Diaz-Kelly, MS
St. John's Episcopal Hospital-South Shore
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Kristen Henry, MS
St. John's Episcopal Hospital-South Shore
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Kelly Mondey, MS
St. John's Episcopal Hospital-South Shore
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Brenna M. Regan, MS
William Carey University College of Osteopathic Medicine
William Carey University / Hattiesburg, Mississippi, United States
Kristen Cohen, CNM, DNP
CNM WHNP-OB
RWJBarnabas Health Trinitas Regional Medical Center
RWJBarnabas Trinitas Regional Medical Center / Elizabeth, New Jersey, United States
Iris Gomez-Brito, CNM, DNP
DNP-CNM
RWJBarnabas Trinitas Regional Medical Center
RWJBarnabas Trinitas Regional Medical Center / Elizabeth, New Jersey, United States
Eddie Santana, DO
MFM Fellow
Good Samaritan University Hospital / NYIT
Good Samaritan University Hospital / West Islip, New York, United States
Angelo Oduro, DO
OBGYN Residency Program Director
St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Jacqueline Marecheau, MD
Chairperson, Department of OB/GYN
St. John's Episcopal Hospital-South Shore
St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States
Intravenous (IV) Levetiracetam (LM) remains a potential alternative to magnesium sulfate (MS) in pregnancies complicated by preeclampsia with severe features (SPEC), yet its comparative efficacy remains undefined. This study sought to evaluate the effectiveness of LM as compared to MS in pregnancies complicated by SPEC.
Study Design:
We conducted a multi-center, prospective observational study from 7/2022 to 7/2025 and included all pregnant women diagnosed with SPEC from 34 0/7 to 41 0/7 weeks-gestation. Patients initially presenting with SPEC in the postpartum period were not included. Both medications were administered IV. Medication choice was based on physician preference. All patients received aspirin 81mg daily. Primary outcomes included progression to eclampsia, events of maternal side-effects or toxicity (TOX), post-treatment development of category II fetal heart rate tracings (CatII), as discrete events. Patients with pre-existing neurologic, renal, hematologic or cardiac disorders, multi-fetal gestations, or Myasthenia Gravis, were excluded.
Results:
The study included 444 patients, with 133 receiving LM and 311 receiving MS. Baseline demographic factors were not significantly different. Patients receiving LM had lower rates of TOX (3.7% v. 10.9% p< 0.001) and CatII (6.8% v. 19.9%, p< 0.001), with an 89% (RR=0.11, 95% CI 0.66-0.94, p=0.002) and 79% (RR=0.29, (95% CI 0.59-0.87, p=0.003) decreased risk in confounder-adjusted models, respectively. Both medications did not have significantly different rates or risk of progression to eclampsia
Conclusion:
Intravenous levetiracetam remains a safe and efficacious alternative to magnesium sulfate for seizure prophylaxis in pregnancies complicated by preeclampsia with severe features, with a potential advantage in preventing maternal and fetal medication-related side-effects.