Safety of anticonvulsant agents in pregnancy

Expert Opinion on Drug Safety
Hind N MoussaBaha M Sibai

Abstract

Seizures in pregnancy are particularly challenging, as their management requires careful consideration of not only the etiology of the seizure, but also the physiologic changes of pregnancy as well as potential adverse effects on the developing embryo or fetus. Newer antiepileptic drugs (AEDs) have increasingly shown promising results of lower rate of teratogenesis, as well as better seizure control during pregnancy. We performed a review of the scientific literature of seizures in pregnancy including status epilepticus as well as eclampsia, with a focus on safety of currently used AEDs. This covers the different generations of antiepileptic medications, their interactions and seizure recurrence preventative measures. In addition, we summarized our personal approach to the care for these women. In summary, morbidity associated with seizure in pregnancy is decreasing as treatments and supportive therapies have improved. The understanding of teratogenesis as well as novel targeted therapeutics will allow women on AEDs during their pregnancy, to receive the safest drug for their developing fetus as well as themselves.

References

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Citations

Jan 23, 2017·Seizure : the Journal of the British Epilepsy Association·Elles J T M van der LouwMackenzie C Cervenka
Nov 12, 2020·Seminars in Neurology·Caroline Der-NigoghossianGretchen M Brophy

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