ABSTRACT
All of the antiepileptic drugs [AEDs] are either known or suspected of being teratogenic. The possible mechanism of teratogenicity is likely to be multiple for the same drug. This is of major concern for all women with epilepsy using these drugs are delicately balanced between seizure control and the adverse effects the AEDs. The use of conventional AEDs eg. Carbamazepine control more than two thirds of the epileptic patients. In recent years, the number of commercially available AEDs has steadily increased eg. lamotrgine and levetiracetam.160 pregnant female albino rats were used in this study. Animals were classified randomly into eight groups; each group contained 20 pregnant female rats. Negative control group received nothing and positive control group received normal saline. Treated groups: each group received either the therapeutic dose or 1/4 LD50 of carbamazepine, lamotrigine or levetriacetam. The drugs were given by gastric tube from 6[th] day up to the 19[th] day of gestation. Teratological evaluation:the fetuses [both living and dead] in each group were weighted their crown rump length measured and morphological examination included: Head size and shape, orofacial development, vertebral column tail and abdomen, umbilicus and external genitalia Maternal findings showed high death rate in 1/4 LD50 of lamotrigine treated group; weight gain was dose dependant with highest effect in the lamotrigine treated groups. The fetal findings showed highest embrolethality and least litter siza in lamotrigine treated groups; while the fetal growth determined by weight gain and crown rumplength was retarded more in carbamazepine and lamotrigine treated groups than in levetiracetam treated groups. The morphological findings revealed that the highest percentage of congenital anomalies were in the dose of 1/4 LD50 of lamotrigine followed by carbamazepine and levetiracetam. The AEDs are potentially teratogenic and in utero exposure can increase the risk of adverse outcomes in off springs born epileptic mothers. The new AED lamotrigine caused gross fetal retardation even in therapeutic dose. Levetiracetam caused growth retardation in the therapeutic dose more than carbamazepine in the corresponding dose although it had the best effect on maternalparameters. As regard the congenital anomalies lamotrigine was the safest durg in the therapeutic dose