Antiepileptic Drugs, Epileptic Seizures and the Foetus
This chapter deals with two main issues, viz. the possible effects of pregnancy on the course of maternal epileptic seizure disorders and the effects of seizure disorders on pregnant women and their foetuses.
The little information that is available suggests that pregnancy tends to increase the risk of loss of seizure control in women whose epilepsy is untreated. The interpretation of the more extensive literature concerning antiepileptic drug-treated epilepsy in pregnancy is confounded by the effect of pregnancy in tending to decrease circulating concentrations of antiepileptic drugs relative to drug dose. It appears that, in the majority of instances, seizure control does not deteriorate during antiepileptic drug-treated pregnancy but that, if seizure control changes, it is more likely to worsen than to improve. However, when attention has been given to maintaining satisfactory pre-pregnancy circulating concentrations of antiepileptic drugs throughout pregnancy, the impaired seizure control seems to be avoided.
There is little published evidence of maternal injury from epileptic seizures during pregnancy or of significantly increased pregnancy complications such as spontaneous abortion or stillbirth, though neonates born to women taking antiepileptic drugs tend to be a little premature, smaller and of lower birth weight for gestation age than would be expected. Seizures during pregnancy do not seem to be a significant cause of foetal damage.
KeywordsAntiepileptic Drug Epileptic Seizure Seizure Control Seizure Disorder Antiepileptic Drug Therapy
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