title: Fetal heart rate during a maternal grand mal epileptic seizure.
abstract: Although maternal ingestion of antiepileptic drugs is strongly suspected of causing congenital defects, particularly oral clefts, the effect of epilepsy itself or a combined effect of drug intake and epilepsy have not been excluded as etiological factors. Very little is known about fetal oxygenation during a maternal grand mal epileptic seizure. We describe two cases in which fetal heart rate was recorded during a maternal epileptic seizure during labor. The first fetus became clearly asphyctic as judged from the fetal heart rate recording: immediately after the epileptic seizure there was a 13-minute continuous bradycardia wave with decreased short-term variability. After the bradycardia a phase of tachycardia with decreased short-term and long-term variability occurred. In the other fetus there was only a short period of bradycardia, which was followed by a phase of tachycardia and decreased short-term and long-term variability. Both fetuses were vigorous at birth 43 and 87 minutes, respectively, after the epileptic seizures of their mothers. We conclude that a maternal grand mal epileptic seizure can be ominous to the fetus. It is therefore important that epileptic seizures are controlled by optimal medication throughout pregnancy.
mesh_terms: D000328:Adult; D004830:Epilepsy, Tonic-Clonic / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005318:Fetal Heart / Q000503:physiopathology*; D005311:Fetal Hypoxia / Q000209:etiology* / Q000503:physiopathology; D005323:Fetal Monitoring; D006339:Heart Rate; D006801:Humans; D007744:Obstetric Labor Complications; D010672:Phenytoin / Q000627:therapeutic use; D011247:Pregnancy
chemical_list: D010672:Phenytoin