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AAN: Pregnancy Is Usually Safe for Epileptics

Last Updated: April 28, 2009.

Female epileptics of childbearing age can expect good pregnancy outcomes if they avoid valproate during pregnancy and take other precautions, according to new guidelines presented at the 61st annual meeting of the American Academy of Neurology held April 25 to May 2 in Seattle and published online April 27 in Neurology.

TUESDAY, April 28 (HealthDay News) -- Female epileptics of childbearing age can expect good pregnancy outcomes if they avoid valproate during pregnancy and take other precautions, according to new guidelines presented at the 61st annual meeting of the American Academy of Neurology held April 25 to May 2 in Seattle and published online April 27 in Neurology.

Cynthia Harden, M.D., of the University of Miami, and colleagues from the American Academy of Neurology and the American Epilepsy Society conducted a comprehensive review of relevant scientific studies.

The authors report that valproate should be avoided during pregnancy because the drug is strongly associated with an increased risk for fetal malformations and cognitive impairment. They also recommend that patients take no more than one antiseizure drug during pregnancy because combination therapies are associated with an increased risk of birth defects, and advise physicians to consider avoiding phenytoin and phenobarbital during patients' pregnancies due to a possible risk of cognitive impairment in children.

"Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant," Harden said in a statement. "These guidelines show that women with epilepsy are not at a substantially increased risk of having a cesarean section, late pregnancy bleeding, or premature contractions or premature labor and delivery. Also, if a woman is seizure-free nine months before she becomes pregnant, it's likely that she will not have any seizures during the pregnancy."

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