Epilepsy and pregnancy: mother and child

Pregnancy in women that have epilepsy is not contraindicated. Definite associated risks do exist but are not as great as once believed. The woman of child bearing age with epilepsy should be educated and informed about the risk of increased seizures and the complications associated with the pregnancy and AED's. Seizure frequency may increase in one-third to one-half of women during pregnancy. AED serum levels decrease during pregnancy and may have a negative impact on seizure control. The risks for mother and child produced by generalized convulsions and especially status epilepticus far outweigh the potential risks associated with AED's. Prenatal obstetrical and neurological care during pregnancies of women with epilepsy is mandatory and can result in an improved outcome. All AED's do have some teratogenic potential, but this is much less than previously described. An understanding of the risks associated with epilepsy and pregnancy and appropriate therapy will result in a better outcome for both mother and child.