Safety of anticonvulsant agents in pregnancy.
BACKGROUND
Seizures in pregnancy are particularly challenging, as their management requires careful consideration of not only the etiology of the seizure, but also the physiologic changes of pregnancy as well as potential adverse effects on the developing embryo or fetus. Newer antiepileptic drugs (AEDs) have increasingly shown promising results of lower rate of teratogenesis, as well as better seizure control during pregnancy.


METHODS
We performed a review of the scientific literature of seizures in pregnancy including status epilepticus as well as eclampsia, with a focus on safety of currently used AEDs. This covers the different generations of antiepileptic medications, their interactions and seizure recurrence preventative measures. In addition, we summarized our personal approach to the care for these women.


CONCLUSIONS
In summary, morbidity associated with seizure in pregnancy is decreasing as treatments and supportive therapies have improved. The understanding of teratogenesis as well as novel targeted therapeutics will allow women on AEDs during their pregnancy, to receive the safest drug for their developing fetus as well as themselves.
a The University of Texas Health Science Center at Houston, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences , 6431 Fannin Street, Suite 3.264, Houston, TX 77030, USA +1 51 36 38 08 23 ; +1 71 35 00 78 60 ; hind.n.moussa@uth.tmc.edu.
Hind N
HN
Moussa
a The University of Texas Health Science Center at Houston, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences , 6431 Fannin Street, Suite 3.264, Houston, TX 77030, USA +1 51 36 38 08 23 ; +1 71 35 00 78 60 ; hind.n.moussa@uth.tmc.edu.
Alejandra Elder
AE
Ontiveros
a The University of Texas Health Science Center at Houston, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences , 6431 Fannin Street, Suite 3.264, Houston, TX 77030, USA +1 51 36 38 08 23 ; +1 71 35 00 78 60 ; hind.n.moussa@uth.tmc.edu.
Ziad A
ZA
Haidar
a The University of Texas Health Science Center at Houston, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences , 6431 Fannin Street, Suite 3.264, Houston, TX 77030, USA +1 51 36 38 08 23 ; +1 71 35 00 78 60 ; hind.n.moussa@uth.tmc.edu.
Baha M
BM
Sibai
D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004461:Eclampsia / Q000188:drug therapy; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012640:Seizures / Q000150:complications / Q000188:drug therapy*; D013226:Status Epilepticus / Q000150:complications / Q000188:drug therapy
D000927:Anticonvulsants
anticonvulsants; drugs; eclampsia; pregnancy; seizures; teratogenesis