ABSTRACT
This paper deals with malformations detected in 26 of 315 newborns of 305 epileptic mothers followed prospectively. In 3 more cases, malformations were detected in utero and therapeutic abortion was performed. Two hundred and seven women were on monotherapy, 102 on polytherapy and 9 were not treated. In total, malformations overall incidence was 9.1%. Minor anomalies were detected in 42 newborns (13.3%). A higher rate of malformations and minor anomalies was found among offspring of mothers treated with valproic acid (VPA). In the VPA group, mothers of malformed babies had higher plasma levels in the first trimester than mothers of babies without malformations. The need for accurate prenatal diagnostic studies in pregnant women with epilepsy is stressed.
Subject(s)
Abnormalities, Drug-Induced/etiology , Anticonvulsants/adverse effects , Epilepsy/drug therapy , Pregnancy Complications/drug therapy , Adolescent , Adult , Anticonvulsants/therapeutic use , Drug Therapy, Combination , Female , Humans , Infant, Newborn , Male , Pregnancy , Prospective Studies , Risk FactorsSubject(s)
Dequalinium/administration & dosage , Hydrocortisone/administration & dosage , Quinolinium Compounds/administration & dosage , Tyrothricin/administration & dosage , Uterine Cervicitis/drug therapy , Vaginitis/drug therapy , Adolescent , Adult , Clinical Trials as Topic , Double-Blind Method , Drug Combinations , Female , Humans , Middle Aged , Therapeutic Irrigation , VaginaABSTRACT
Plasma concentrations of primidone and its metabolite phenobarbitone were monitored in 9 pregnant epileptic patients treated with primidone (and in 3 cases other antiepileptic drugs) given at constant doses throughout pregnancy and the puerperium. Phenobarbitone plasma concentrations were monitored in another 6 patients given phenobarbitone itself. A trend towards increasing primidone plasma concentrations during the second quarter of pregnancy was evident in all patients, with a concomitant significant decrease in primidone-derived phenobarbitone plasma concentrations. A trend towards a lowering of plasma concentrations of phenobarbitone administered as such was confirmed. These results suggest the usefulness of a careful monitoring of primidone and primadone-derived phenobarbitone during pregnancy and the puerperium. Discrepancies of findings with primidone and phenobarbitone are discussed in view of the possible mechanism involved.
