Pregnancy, epilepsy, management and outcome: a 10-year perspective.
We analysed the management and outcome of 348 pregnancies in 207 women with epilepsy from 1977 to 1981 and 1987 to 1991. Outcome was successful in 88%. There was a marked change in anticonvulsant prescribing away from phenobarbitone and phenytoin towards carbamazepine and sodium valproate but a large number of patients (24%) were treated with two or more anticonvulsants in the second cohort despite a move towards monotherapy. A significant reduction in congenital malformation (4.8%), spontaneous abortion (6.9%) or low birth weight babies (9.4%) was not seen. Until experience is gained with the newer agents, monotherapy remains of major importance in the management of the pregnant woman with epilepsy.
Martin
P J
PJ
Department of Neurology, Leicester Royal Infirmary, UK.
Millac
P A
PA
D000014:Abnormalities, Drug-Induced / Q000209:etiology*; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001724:Birth Weight / Q000187:drug effects; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012307:Risk Factors; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid; D010672:Phenytoin