Epilepsy and pregnancy: Latest news, Do’s and Don’ts

Introduction: Epilepsy and pregnancy is one of the most challengeable topics in epilepsy management and both for the epileptologist and patients is very stressful.Methods: This review will outline risks for epilepsy during pregnancy, first seizure in pregnancy, and provide an evidence-based approach for managing patients with epilepsy before, during, and after pregnancy. This is a systematic review about this topic in recent five years.Results: Despite differences in methodology, all registries have reported similar findings and have all noted that exposure to VPA poses the greatest risk for MCMs. They have also shown that both lamotrigine and levetiracetam have a relatively low potential. Polytherapy has been shown to increase the risk for major congenital malformation and monotherapy is preferred.Neurodevelopmental finding showed increased risk of autism spectrum disorders and significantly reduced IQ scores with VPA in comparison to other ASMs. Changing medications while pregnancy exposes the patient and her fetus to the unknown effectiveness of the new ASM and placing the woman at risk of having seizures that may be a cause of fetal asphyxia, bradycardia, direct injury also mortality.Conclusion: Epilepsy is not a contraindication to pregnancy. Successful management of these pregnancies therefore ideally involves pre-pregnancy consultation and close collaboration between the obstetric and neurology providers as a multidisciplinary team.

کلیدواژه ها:

Epilepsy ، Pregnancy ، Management