epileptic women needs to be weaned off their anticonvulsants before their conception, can anybody explain pls.
my concept was both epilepsy and anticonvulsants both have higher risk of congenital anomolies and minimum dose of anti convulsants to keep them seizure free is needed.
am i rt or should i change.
does this mean weaning off to a minimum dose to be disease free
Seizure Disorders in Pregnancy
Seizure disorders may impair fertility. Also, certain anticonvulsants may make oral contraceptives less effective, resulting in unintentional pregnancy.
If women get enough sleep and anticonvulsant levels are kept in the therapeutic range, seizure frequency does not usually increase during pregnancy, and pregnancy outcome is good; however, risks of preeclampsia, fetal growth restriction, and stillbirth are slightly increased. Generally, uncontrolled seizures are more harmful during pregnancy than is use of anticonvulsants; thus, the top priority of treatment during pregnancy is to control seizures. However, the minimum number of anticonvulsants in the lowest possible dose necessary to control seizures is used. Anticonvulsants slightly increase risk of congenital malformations and may tend to slightly decrease intelligence in offspring; mental retardation may be a risk. Risk of hemorrhagic disease of the newborn (erythroblastosis neonatorum) may be increased by in utero exposure to anticonvulsants (eg, phenytoin Some Trade Names
); however, if prenatal vitamins with vitamin D are taken and vitamin K is given to the neonate, hemorrhagic disease is rare.
Ref: Merck Manual
thank you angleman, so basically weaned off to maintain seizure free, but not completely taken off.