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To reduce the risk of birth defects, women taking medicines for epilepsy and planning a family are advised to prepare well before pregnancy, according to an article in the current edition of Australian Prescriber.
The article by Cecilie Lander, Associate Professor of Neurology at the University of Queensland, says no antiepileptic medicine is completely safe to use in pregnancy because of the increased risk of birth defects.
The article states that pregnant women with epilepsy who are on antiepileptic medicines have two to three times more risk than other women of having a baby with an abnormality. Taking more than one medicine may carry an even greater risk. There are recent concerns that children who have been exposed to antiepileptic medicines during pregnancy may develop problems such as language impairment and autistic disorders.
Sodium valproate is a highly effective and sometimes essential antiepileptic drug but it is arguably the one most associated with fetal abnormality. Thus, there is a delicate balance for pregnant women with epilepsy between controlling their condition and protecting the health of their unborn child.
Uncontrolled epilepsy in pregnancy can be potentially life-threatening for both mother and child.
“Most pregnant women with epilepsy will need to take at least one antiepileptic drug. The goal for all concerned is a healthy, seizure-free mother and an undamaged child,” Associate Professor Lander says.
She recommends that women with epilepsy who are thinking about motherhood should talk to their doctor to arrange a management plan during pregnancy. She says women should be treated with the most appropriate antiepileptic medicine for their particular type of epilepsy, at the lowest effective dose.
Associate Professor Lander also recommends that all potentially reproductive women with epilepsy take folate supplements, even if they are not currently contemplating pregnancy.
For the complete article visit the Australian Prescriber website www.australianprescriber.com.
AAP