@article{oai:hirosaki.repo.nii.ac.jp:00003522,
 author = {Kaneko, Sunao},
 issue = {3},
 journal = {弘前医学},
 month = {Sep},
 note = {application/pdf, Clinical and basic researches on epilepsy and pregnancy. in particular of antiepileptic
drugs (AEDs) on the fetus and the epileptic mother, and those of pregnancy on the course of
epilepsy were reviewed.
The complete control of seizures in the pregestational period and regular drug taking are very
important for better management of pregnant epileptics with medication, since the seizure frequency
remains mostly unchanged when the patient's compliance is good. If the serum level
decreases, one must confirm the patient's compliance. Once compliance has been established, the
dose should be increased only when seizures occur.
Most AEDs cross the placenta and some cause unwanted effects on the embryo, the fetus, or
the newborn.
Thus pre-conceptional counselling should ensure that an epileptic embarks upon a pregnancy
with her epilepsy well controlled by a minimal dose of AEDs, and adequate answers for the questions
raised by the patient should be given to prevent poor compliance.
There is an increased risk of major congenital malformations among the offsprings of women
with epilepsy, most of whom are on AEDs. Part of this increase is due to exposure to AEDs.
Other factors also appear to play an important role. Prevention of malformation can take place
before the onset of the pregnancy by decreasing the dose of the drug and/or changing from a
combination of AEDs to a single drug, since there is a dose-response relation for teratogenesis
and a greater occurrence of congenital malformation when the mother receives combined AED
therapy.
An aspect of prenatal growth deficiency that has raised concern is that brain growth may be
affected, producing microcephaly and mild to moderate mental retardation. However, the delay
in the physical development of the offspring may be transient. The psychomotor retardation
continued only through infancy. if they were nursed properly., 弘前医学. 38(3), 1986, p.434-456},
 pages = {434--456},
 title = {Epilepsy, Pregnancy and Antiepileptic Drugs},
 volume = {38},
 year = {1986}
}