Epilepsy and pregnancy [Review]

摘要

Pregnancy poses special problems to women with epilepsy. Seizures may aggravate in up to a third of such women, while others may experience no change or even an improvement. Teratogenic potential of anti-epileptic drugs (AEDs) remains the major concern for women with epilepsy, although close to ninety per cent of babies born to mothers taking AEDs are healthy. All commonly used AEDs have been implicated with fetal malformations. Several factors, such as concomitant use of two or more AEDs, very high daily dose, lack of folate administration and positive family history, have been identified as risk factors for fetal malformations. Several measures can be taken in the preconception period and pregnancy to reduce the risk of malformations and other complications of pregnancy and epilepsy. Access to a well-informed and proactive counselor is very helpful to the patients and their families in handling the diverse issues related to epilepsy and pregnancy. Women with epilepsy need an integrated care, from neurologist, gynaecologist and other specialists.