Document Detail


Epilepsy and pregnancy.
MedLine Citation:
PMID:  12185759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pregnancies in women with epilepsy are high risk and need careful management by both the medical and obstetric teams due to the increased incidence of complications and adverse outcomes of pregnancy. By the time a pregnant woman with epilepsy presents, the foetus is virtually fully formed and the opportunity for altering drug treatment has passed. Women need to be counselled and told to seek advice about their anticonvulsant therapy should they wish to become pregnant. All major anticonvulsant drugs are teratogenic but the main risk to the developing foetus appears to be when the mother is on polytherapy especially if sodium valproate forms part of the combination. Folate supplements (5 mg) before conception are advisable. There appears to be a minor but significant increased risk of maternal complications in women with epilepsy such as hyperemesis gravidarum, pre-eclampsia and eclampsia, vaginal bleeding and premature labour. In the majority of women seizure control will not alter during pregnancy. Oral vitamin K should be given to the mother receiving enzyme-inducing antiepileptic drugs. POST-NATAL INFANT DEVELOPMENT: There is an increased risk of prematurity (9-11%), stillbirth, neonatal and perinatal death, haemorrhagic disease of the newborn, low Apgar scores and low birth weight (7-10%). BREAST FEEDING: Virtually all the anticonvulsant drugs are excreted in breast milk in low concentrations. Feeding difficulties, irritability and lethargy can occur. However, the benefits of breast feeding usually far outweigh any minor risks to the baby.
Authors:
Pamela Crawford
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seizure     Volume:  11 Suppl A     ISSN:  1059-1311     ISO Abbreviation:  Seizure     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-08-20     Completed Date:  2002-11-29     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  212-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / blood,  pharmacology,  therapeutic use*
Embryonic and Fetal Development / drug effects
Epilepsy / prevention & control*
Female
Fetal Diseases / prevention & control
Folic Acid / therapeutic use
Humans
Pregnancy
Pregnancy Complications*
Prenatal Care
Valproic Acid / blood,  pharmacology,  therapeutic use*
Vitamin K / therapeutic use
Chemical
Reg. No./Substance:
0/Anticonvulsants; 12001-79-5/Vitamin K; 614OI1Z5WI/Valproic Acid; 935E97BOY8/Folic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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