Epilepsy: Pregnancy and Breast Feeding

Question 1

What should all women on AEDs take that are thinking about becoming pregnant?

Answer 1

Folic Acid 5 mg

(400mcg in other women)

Question 2

How does the precentage risk of congenital defects increase in mothers taking AEDs compared to non-epileptic mothers?

Answer 2

Congenital defects of babies in non-epilpetic women is 1-2%

3-4% in mothers taking AEDs.

Question 3

Is breast feeding safe on anti-epileptics?

Answer 3

Yes

Question 4

What should pregnant women taking phenytoin be given in the last month of pregnancy?

Answer 4

Vitamin K to prevent clotting disorders.

Question 5

What is sodium valproate particularly associated with?

Answer 5

Neural tube defects

Question 6

Which is the least teratogenic of the older antiepileptics?

Answer 6

Carbamazepine

Question 7

What congenital defect is phenytoin associated with?

Answer 7

Cleft palate

Question 8

If someone is taking lamotrigine, what might need to be done with it?

Answer 8

Increased in pregnancy.

Question 9

What did the Drug Safety Update say in Novemebr 2013 about Sodium Valproate/

Answer 9

• There was evidence showing a neurodevelopmental delay in children following maternal use in pregnancy.
• They advised that sodium valproate whould not be used during pregnancy or in women of child bearing age unless absolutely necessary.
• They should not be started without specialist neurological or psychiatric advice.