PRECONCEPTION COUNSELING FOR EPILEPTIC MOTHERS TREATED WITH ANTIEPILEPTIC DRUGS

Planning a pregnancy for a woman diagnosed with epilepsy might be a challenge, but nowadays it is no more a contraindication. By offering careful education to this population, maternal and neonatal normal outcome is expected.It is important to have a multidisciplinary team of professionals that include a neurologist, a maternal fetal medicine specialist, an obstetrician and an anesthesiologist that manage the case and inform the women about potential risks for them and for fetuses, evolution of their scheme of treatment and particular adjustments that they need to do, as well as advices and strategies for postpartum period. The goal should always be optimal seizure control and minimal exposure to antiepileptic drugs for fetus. Preconception counseling should accomplish the four most important steps for the benefits of both mother and fetus: particular choice of antiepileptic drugs and the lowest effective dose, valproate avoidance, folate supplementation and birth control with contraceptives until baseline is achieved.Finally, although there is an increased risk for congenital malformations and neurodevelopment disorders, a good managed pregnancy can maintain to a minimum the fetal exposure to side effects of antiepileptic drugs and maternal risk for seizure