Pregnancy and Epilepsy |
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Authors: | Mark S. Yerby |
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Affiliation: | Oregon Comprehensive Epilepsy Program, Good Samaritan Hospital and Medical Center, Portland, Oregon, U.S.A. |
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Abstract: | Summary: : Women with epilepsy account for approximately 0.5% of all pregnancies. Their pregnancies are high risk because of an increased frequency of maternal seizures, complications of pregnancy, and adverse pregnancy outcomes. The increase in seizure frequency is associated with a progressive decline in antiepileptic drug (AED) levels during pregnancy even with constant dosing. Fetal deaths after a generalized seizure, although rare, have been reported, and a marked decline in fetal heart rate has been demonstrated after such seizures during delivery. AEDs have been implicated in causing a twofold increase in the rate of congenital malformations, a variety of minor physical anomalies, mostly involving the midface, and a neonatal hemorrhagic disorder. The clinician caring for a pregnant woman with epilepsy is therefore faced with a dilemma and must carefully chart a middle ground providing effective seizure control while minimizing fetal exposure to AEDs |
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Keywords: | Pregnancy Epilepsy Anticonvulsants Drug-induced abnormalities Congenital abnormalities Teratogens |
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