МРТ головного мозга при беременности

[FRSM]

Pregnancy There is an increased risk of teratogenicity associated with the use of antiepileptic drugs (especially if the patient takes two or more antiepileptic drugs). However, the benefit of antiepileptic treatment usually outweighs the potential teratogenic risk, and treatment should not be stopped during pregnancy without discussing with a specialist (see also under individual drugs). In view of the increased risk of neural tube and other defects associated, in particular, with carbamazepine, lamotrigine, oxcarbazepine, phenytoin, and valproate, women taking antiepileptic drugs who may become pregnant should be informed of the possible consequences. Those who wish to become pregnant should be referred to an appropriate specialist for advice. Women who become pregnant should be counselled and offered antenatal screening (alpha-fetoprotein measurement and a second trimester ultrasound scan).

To counteract the risk of neural tube defects, adequate folate supplements are advised for women before and during pregnancy (section 9.1.2).

The concentration of antiepileptic drugs in the blood can change during pregnancy, particularly in the later stages. The dose of antiepileptic drugs should be monitored carefully during pregnancy and after birth, and adjustments made on a clinical basis.

Routine injection of vitamin K (section 9.6.6) at birth effectively counteracts any antiepileptic-associated risk of neonatal haemorrhage.

British National Formulary
Oct. 2010

4.8.1 Control of epilepsy