The management of epilepsy in pregnancy.
While most women with epilepsy can expect a normal pregnancy outcome, epilepsy remains a significant contributor to both maternal and perinatal morbidity. Pre-pregnancy planning must address reliable contraception and optimisation of antiepileptic drug (AED) regimens to minimise teratogenic risk while maintaining seizure control. The most recent data from the AED registries regarding malformations is presented in this review, as is the limited data on the newer AEDs and studies linking neurocognitive outcomes to AED exposure. During pregnancy, important considerations include; therapeutic drug monitoring, surveillance for obstetric complications and vigilance for seizures during the intrapartum and postpartum period.
Walker
S P
SP
Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Vic., Australia. spwalker@unimelb.edu.au
Permezel
M
M
Berkovic
S F
SF
D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011181:Postnatal Care / Q000379:methods; D016742:Preconception Care / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects
D000927:Anticonvulsants