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Epilepsy and Pregnancy

  • Mariel Velez
  • Kimford J. Meador
Chapter

Abstract

Managing epilepsy in pregnancy poses a unique challenge for the clinician given the need to balance seizure control with the potential teratogenic effects of antiepileptic drugs (AEDs) on the developing fetus. It has been estimated that 0.3–0.5% of all pregnancies occur in women with epilepsy (WWE) (Levy and Yerby. Epilepsia. 1985; 26(s1):S52–7). Given that a large portion of pregnancies are unplanned, careful consideration of AEDs with low risk to the fetus should be made in every WWE of childbearing age before they conceive. Once pregnant, monitoring of AEDs is important because metabolic and hormonal changes affect AED levels. After the child is born, women should be encouraged to breastfeed, even if taking AEDs, given that the benefits of breastfeeding and the evidence that no detrimental effects occur in studies directly assessing child outcomes.

Keywords

Pregnancy Women with epilepsy Major congential malformations Breastfeeding Anti-epileptic drugs Valproic acid 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mariel Velez
    • 1
  • Kimford J. Meador
    • 2
  1. 1.California Pacific Medical CenterCalifornia Pacific Neurosciences InstituteSan FranciscoUSA
  2. 2.Department of Neurology and Neurological SciencesStanford UniversityPalo AltoUSA

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