[Pregnancy and fetal development in epileptic women]

Epilepsy affects almost 1% of all pregnant women. Epileptic women marry more often than epileptic men. Married epileptic women have a lower socio-economic status and are more severely ill than married male epileptics.--Several reasons are discussed--poor compliance being probably the most essential one--for an explanation of an occasional increase in the rate of attacks and a frequently observed tendency to a drop in plasma concentrations of anti-epileptics during pregnancy. Pregnancy and parturition are not more complicated in epileptic women than in non-epileptics women. Nevertheless, abortions are performed, and delivery by surgery is initiated, more often with epileptics, although there are no convincing arguments in favour of such procedures. For unknown reasons, perinatal lethality is up to twice as high than with controls.--Children of mothers treated with anti-epileptics have a tendency to intrauterine dystrophia, which is manifested mainly by a reduced size of the head which is not made up completely during the first few years of life, contrary to other body dimensions. We do not know as yet whether there are any links between dystrophia of the body, malformations and inhibited psychomotoric development.--Depending on the type of anti-epileptics given to the mothers who are breast-feeding their children, and on the concentration of these drugs in the plasma or in the mother's milk, breast-fed children may display signs of withdrawal or sedation. This must not be overlooked when considering the problem of breast-feeding.--The slightly enhanced risk of malformations appears to be less intimately connected, with intrauterine exposition of anti-epileptics than with the underlying disease itself.(ABSTRACT TRUNCATED AT 250 WORDS)