Navigation Links
Pregnant Women With Epilepsy Should Avoid Valproate
Date:4/27/2009

New guidelines stress that, with good planning, most moms-to-be will do fine,,,,

MONDAY, April 27 (HealthDay News) -- Despite recent concerns about fetal malformations linked to the anti-seizure medication valproate, most women with epilepsy can expect to have a relatively uneventful pregnancy with careful planning and preparation, say new guidelines from the American Academy of Neurology.

Whenever possible, women should avoid taking valproate (Depakote) while pregnant, the guidelines state, because its use has been associated with fetal malformations and a decline in cognitive abilities in children whose mothers took the drug during pregnancy.

However, "women with well-controlled epilepsy can safely have children," stressed the lead author of the new guidelines, Dr. Cynthia Harden, director of the epilepsy division at the University of Miami Miller School of Medicine.

"There have been a lot of myths circulating about epilepsy and pregnancy, and even some doctors have told women they can't have children if they have epilepsy," she said. "By using a rigorous, scientific approach to come up with these guidelines, we're dispelling a lot of those myths."

For example, the guideline authors found that women with epilepsy don't have a significantly increased risk of having a cesarean section, late pregnancy bleeding, premature labor or premature delivery.

The new guidelines are scheduled to be presented at the American Academy of Neurology's annual meeting in Seattle on Monday and will be published online in the journal Neurology.

There are about half a million women with epilepsy in the United States, according to the guidelines. Out of every 1,000 births, there are between 3 and 5 infants born to women with epilepsy.

Harden said that women who are seizure-free for at least nine months prior to pregnancy will likely go through their whole pregnancy seizure-free as well. But, the guideline authors did recommend that medication levels be checked periodically throughout the pregnancy, because pregnancy can cause levels of seizure medications in the blood to drop.

Pre-pregnancy planning is key, according to the guidelines. The ideal is to be on one anti-seizure medication and to be on the lowest dose possible during pregnancy. And the time to experiment with different medications is before you get pregnant.

While it's best to avoid certain drugs, such as valproate and also phenytoin and phenobarbital, according to the guidelines, it's not always possible to do so. Some women must use these medications to control their seizures. And, having seizures during pregnancy is dangerous for both mother and baby.

"There are women who need to take valproate," said Harden, who added that these women should talk to their doctors to assess the risks before pregnancy. "The risk of malformations is higher, but 90 percent of babies born to women on valproate will not have major malformations," she said.

A study in the April 16 issue of the New England Journal of Medicine found that valproate could cause lasting cognitive impairment in children exposed in-utero to the drug. And the study's lead author recommended that valproate shouldn't be a first-line medication for women of childbearing age, because so many pregnancies are unplanned.

Dr. Orrin Devinsky, director of the Epilepsy Center at New York University's Langone Medical Center, said he agreed with that recommendation. However, if a woman must be on valproate during pregnancy, she should try and get to the lowest levels possible and be aware of the risks. "Pregnancy is a risk/benefit decision for each woman," he noted.

As in women without epilepsy, smoking can increase the risk of premature labor and delivery in women with epilepsy, the experts added.

The guidelines also recommend that women with epilepsy follow the standard recommendation to take 400 international units of folic acid daily to help prevent birth defects.

"Before a woman with epilepsy gets pregnant, she should consult a doctor who's knowledgeable about epilepsy and pregnancy, reduce medications if possible, and start taking folic acid," said Devinsky, adding that "women who are well-controlled going into pregnancy tend to do well in pregnancy."

More information

To learn more about epilepsy and pregnancy, visit the Epilepsy Foundation.



SOURCES: Cynthia Harden, M.D., director, epilepsy division, University of Miami Miller School of Medicine, Fla.; Orrin Devinsky, M.D., director, Epilepsy Center, New York University Langone Medical Center, and professor of neurology, neurosurgery and psychiatry, New York University School of Medicine, New York City; April 27, 2009, Neurology online


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Eating junk food whilst pregnant and breastfeeding may lead to obese offspring
2. Another Reason Not to Smoke While Pregnant: Birth Defects
3. Passive smoking increases sleep disturbance among pregnant women
4. Teen girls report abusive boyfriends try to get them pregnant
5. Multiple corticosteroid injections in pregnant women may increase cerebral palsy
6. Stop-Smoking Therapies Have Benefits, Risks for Pregnant Women
7. New transfusion rules restrict donations from previously pregnant women
8. Statement by Gerald Leape, Vice President, Marine Conservation, National Environmental Trust, on a New Recommendation From Scientists Urging Pregnant Women to Eat More Fish
9. Fish Safe for Pregnant Women to Eat
10. Purified Fish Oil Concentrates Offer Solution to Current Seafood Controversy for Pregnant and Breastfeeding Women!
11. Thyroid Test Wont Help Pregnant Mom, Baby
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Pregnant Women With Epilepsy Should Avoid Valproate
(Date:5/26/2016)... ... May 26, 2016 , ... Development Team of Pixel Film Studios ... , "This new layered style transition tool will keep a consistent flow to your ... Pixel Film Studios. , TranSweep is an all new layered style transition tool ...
(Date:5/26/2016)... ... May 26, 2016 , ... In 1980, Bill Howe ... calls throughout the beach community. His vision to grow the company was built on ... they maintain the highest level of training and customer service. Over 35 years later, ...
(Date:5/26/2016)... ... ... In Madeira Beach Florida, a small town with 4,300 residents on a ... Madeira Beach United, to oppose two development projects undertaken by their city government that ... rise urban environment. , According to the Tampa Bay Times on May ...
(Date:5/26/2016)... ... 2016 , ... Dalton Pharma Services, a leading Contract Development ... Health Canada inspection and has received a compliant rating from the Health Products ... Manufacturing Practices (GMP) inspection conducted at Dalton’s facility during March 2016. , ...
(Date:5/26/2016)... ... May 26, 2016 , ... According to the Webster’s dictionary, a hippie ... chemical-laden beauty products, one company is going against the norm with a line of ... rising star in the green space is proud to announce its latest retail partnership ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... 25,2016 FDA 510(k) clearance ... platform for urological and surgical applications ... of Cellvizio®, the multidisciplinary confocal laser endomicroscopy (CLE) ... the US with the 12 th 510(k) ... (FDA). This new FDA clearance covers Confocal Miniprobes ...
(Date:5/25/2016)... PUNE, India , May 25, 2016 ... "Medical Animation Market by Type (3D, 2D, 4D), by ... Patient Education), by End User (Medical Device Manufacturers, Hospitals/ ... report studies the global Medical Animation Market for the ... expected to reach USD 301.3 Million by 2021 from ...
(Date:5/25/2016)... Deutschland und GERMANTOWN, Maryland , ... Zusammenarbeit mit Therawis bedient dringenden ...   QIAGEN N.V. (NASDAQ: ... bekannt, eine Lizenz- und Entwicklungsvereinbarung mit Therawis Diagnostics ... die Onkologie eingegangen zu sein. Ein erstes Projekt ...
Breaking Medicine Technology: