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Phenobarbital
Diagnosis & Treatment > Seizure Medications > Phenobarbital > Pregnancy and Phenobarbital
 

Pregnancy and Phenobarbital

Women who may become pregnant should be aware that studies have suggested a connection between phenobarbital and a higher-than-expected incidence of birth defects.

The risk of defects is higher for women who take several medicines, and for women with a family history of birth defects.

Women who are capable of becoming pregnant should be advised to take 400 mcg (0.4 mg) of folic acid (folate) daily to help prevent neural tube defects. Women at high risk, such as those with a history of a neural tube defect in a previous pregnancy, should take 4000 mcg (4 mg) daily, beginning before they become pregnant.

Check the levels of Mysoline in the woman's blood at intervals during pregnancy, since changes in her body may affect them. Dosage adjustments may be needed to prevent seizures or side effects.

During the last month of pregnancy, the woman should take 10 mg per day of vitamin K to prevent a bleeding disorder that affects some babies born to mothers who are taking anticonvulsants.

No studies have been performed to demonstrate the effect of specific AEDs during labor and delivery. Possible causes of seizures include:

  • failure or inability to take medication
  • sleep deprivation
  • hyperventilation
  • stress
  • pain

There also is a danger to the baby from withdrawal symptoms if the mother has taken phenobarbital in the last few months of pregnancy, since phenobarbital crosses the placenta into the baby.

Since phenobarbital reduces the effectiveness of oral contraceptives (birth control pills), women of childbearing potential should be especially cautious.