[Prenatal ultrasonographic diagnosis in the epileptic mother on valproic acid. Retrospective study of 161 cases in the central eastern France register of congenital malformations].
OBJECTIVE
To assess the reality and efficacy of antenatal ultrasound diagnosis in epileptic women on valproic acid.


METHODS
From the France/Central-Est registry of malformations we selected both fetuses and infants presenting with malformations born to epileptic women treated with valproic acid alone or in combination regimens. We studied the evolution in the number of cases diagnosed in utero according to the period, the nature of treatment and the type of malformation.


RESULTS
Among the 161 women undergoing valproic acid treatment, 60% were valproic acid alone. This rate was about 100% during the years 1994-1996. About 30% of fetuses/newborns presented with at least one of the malformations usually associated with epilepsy, namely oral clefts and heart diseases. The improvement in the rate of ultrasound diagnosis was the most pronounced for these pathologies. Other major anomalies were specific of valproic acid, accounting for 30% approximately of the malformations observed: 35 spina bifida, 18 hypospadias and 6 limb reductions.


CONCLUSIONS
Any ultrasound examination carried the monitoring of pregnant women should assess morphology and should in the future make it possible to diagnose most of the major malformations of fetus from epileptic women treated with valproic acid.
Service de Gynécologie-Obstétrique, Hôtel-Dieu, Lyon.
R
R
Bradaï
E
E
Robert
D000014:Abnormalities, Drug-Induced / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000927:Anticonvulsants / Q000009:adverse effects*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012042:Registries; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014635:Valproic Acid / Q000009:adverse effects*
D000927:Anticonvulsants; D014635:Valproic Acid