The management of epilepsy in pregnancy
Article first published online: 23 APR 2009
© 2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 116, Issue 6, pages 758–767, May 2009
How to Cite
Walker, S., Permezel, M. and Berkovic, S. (2009), The management of epilepsy in pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology, 116: 758–767. doi: 10.1111/j.1471-0528.2009.02141.x
- Issue published online: 23 APR 2009
- Article first published online: 23 APR 2009
- Accepted 26 January 2009.
While most women with epilepsy can expect a normal pregnancy outcome, epilepsy remains a significant contributor to both maternal and perinatal morbidity. Pre-pregnancy planning must address reliable contraception and optimisation of antiepileptic drug (AED) regimens to minimise teratogenic risk while maintaining seizure control. The most recent data from the AED registries regarding malformations is presented in this review, as is the limited data on the newer AEDs and studies linking neurocognitive outcomes to AED exposure. During pregnancy, important considerations include; therapeutic drug monitoring, surveillance for obstetric complications and vigilance for seizures during the intrapartum and postpartum period.