The use of acetazolamide during pregnancy in intracranial hypertension patients.
BACKGROUND
Acetazolamide is the mainstay of medical therapy for idiopathic intracranial hypertension (IIH). Its use in pregnant women has not been recommended because of reported teratogenic effects in rodents and rabbits. However, the safety of acetazolamide use during human pregnancy remains unclear. We report the pregnancy and offspring outcomes in women with intracranial hypertension (IH) treated with acetazolamide during pregnancy.


METHODS
Data were collected through questionnaires sent to patients with IH and their physicians. The questionnaires focused on IH diagnosis, obstetric history and outcomes, and pediatric outcomes.


RESULTS
A total of 101 women with IH were consented (total of 158 pregnancies) and acetazolamide usage before 13 weeks of gestation was reported in 50 pregnancies. The risk of spontaneous abortion was similar to the control group and no major complication was identified in the offspring of women treated with acetazolamide.


CONCLUSIONS
There is no convincing evidence for an adverse effect for acetazolamide use in human pregnancy, even when prescribed prior to the 13th week of gestation. While the liberal use of acetazolamide should be avoided during pregnancy, this medication should remain a treatment option in pregnant women when clinically indicated.
Department of Ophthalmology, Oregon Health and Science University, Portland, OR, USA. falardea@ohsu.edu
Julie
J
Falardeau
Brenna M
BM
Lobb
Sara
S
Golden
Steven D
SD
Maxfield
Emanuel
E
Tanne
D000086:Acetazolamide / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011559:Pseudotumor Cerebri / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000086:Acetazolamide