Identification of fetal problems associated with anticonvulsant usage and maternal epilepsy

This article reviews the general approach for assessing teratogenic risks related to fetal exposure, concentrating on the specific patterns associated with anticonvulsant usage and maternal epilepsy. Major anomalies that might be detected prenatally are presented, as well as the patterns of minor anomalies (syndromes) that might be detected at birth or later. Each of the specific drugs used in the treatment of epilepsy is reviewed in detail. In addition, recent information concerning genetically determined variations in the metabolism of antiepileptic drugs is discussed in light of how genetic factors might relate to teratogenicity.