ACTIVITY VIEW

MANAGEMENT OF EPILEPSY IN WOMEN OF CHILD BEARING AGE

Effects of AEDs on the fetus

 

<< Effects of epilepsy on pregnancy Seizures in labor >>

 

Risk of teratogenicity from AEDs is well documented and has been recognized since early 1970s. This risk has doubled over the last three decades. Generally, there is a 3% risk of teratogenicity with use of AEDs. This risk increases with various AEDs and poly-therapy. If one AED is used, teratogenicity risk is 7%. Use of two AEDs increases the risk to 13%, and use of more than two AEDs further increases the risk to 15%. Combination use of valproate, Carbamezapine and Phenobarbitone or Phenytoin further raises the risk of developing major congenital malformations to 50%. Various antiepileptic drugs have their individual risk profile for teratogenicity. Mothers who have epilepsy and are not on AEDs have a 2.6% chance of developing major congenital malformations. Lamotrigine has a 2.1% chance of teratogenicity, Carbamezapine a 2.2% chance, phenytoin a 3.0% chance and valproate a 6-9% chance. Lamotrigine and valproate combination have a 10.3% chance of teratogenicity.

 

Minor malformations and Dysmorphism such as epicanthus and digital hypoplasia are reported in 55% of babies born of mothers with epilepsy who have been on continued use of AEDs

Valproate teratogenicity has been noted to result in 12% of neural tube defects. Dysmorphism is seen in 10-15% of the off-springs.

Carbamezapine as mono-therapy is relatively the safest AED in pregnancy and no impairment of intelligence has been noted. Lamotrigine has a safety profile close to that of Carbamezapine.

There has been an influx of new antiepileptic drugs over the la last two decades or so.

These include Gabapentine, Topiramate, Vigabatrin and Leviteracetam amongst others. In general teratogenicity profile of the newer antiepileptic drugs is still being studied.

 

<< Effects of epilepsy on pregnancy Seizures in labor >>

 




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Release date: 10-10-2013
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