Because of the potential for malformations, the couple expecting a child exposed to AEDs in utero should be counseled about the risks and offered appropriate screening. This is especially true if either parent has a history of an inherited disorder. An ultrasound at 10-12 weeks of gestation should be performed to detect neural tube defects early in the pregnancy. Women with epilepsy also should have prenatal testing with measurements of maternal a-fetoprotein levels by 14 to 16 weeks of gestation and high-level ultrasonography at 16 to 20 weeks of gestation to evaluate the fetus further for any major structural abnormalities. Depending on the results, amniocentesis with measurement of a-fetoprotein and acetylcholinesterase levels should be considered.30,38,41
Reviewed February 2004 by Cynthia Harden, MD, Weill Cornell Medical College.
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