Pregnant Women With Epilepsy Should Avoid Valproate

April 28 -- MONDAY, April 27 (HealthDay News) -- Despite recent concerns about fetal malformations linked to the anti-seizure medication valproate, most women with epilepsy can expect to have a relatively uneventful pregnancy with careful planning and preparation, say new guidelines from the American Academy of Neurology.

Whenever possible, women should avoid taking valproate (Depakote) while pregnant, the guidelines state, because its use has been associated with fetal malformations and a decline in cognitive abilities in children whose mothers took the drug during pregnancy.

However, "women with well-controlled epilepsy can safely have children," stressed the lead author of the new guidelines, Dr. Cynthia Harden, director of the epilepsy division at the University of Miami Miller School of Medicine.

"There have been a lot of myths circulating about epilepsy and pregnancy, and even some doctors have told women they can't have children if they have epilepsy," she said. "By using a rigorous, scientific approach to come up with these guidelines, we're dispelling a lot of those myths."

For example, the guideline authors found that women with epilepsy don't have a significantly increased risk of having a cesarean section, late pregnancy bleeding, premature labor or premature delivery.

The new guidelines are scheduled to be presented at the American Academy of Neurology's annual meeting in Seattle on Monday and will be published online in the journal Neurology.

There are about half a million women with epilepsy in the United States, according to the guidelines. Out of every 1,000 births, there are between 3 and 5 infants born to women with epilepsy.

Harden said that women who are seizure-free for at least nine months prior to pregnancy will likely go through their whole pregnancy seizure-free as well. But, the guideline authors did recommend that medication levels be checked periodically throughout the pregnancy, because pregnancy can cause levels of seizure medications in the blood to drop.