Although epileptic seizures and the use of antiepileptic drugs pose numerous adverse consequences for pregnant women and their fetuses—with children born to mothers taking antiepileptic drugs having a 2-3 times higher risk of birth defects compared to the general population—timely and appropriate management can still yield relatively favorable outcomes.
1. Female epilepsy patients whose seizures have been controlled for 2-5 years prior to conception, with minimal or no recent episodes, normal EEG recordings, and no structural neurological damage may consider discontinuing medication before pregnancy while monitoring blood drug levels.If antiepileptic drugs are still required during pregnancy to control seizures, monotherapy with a low dose should be selected based on seizure type.Individuals with a family history of neural tube defects should avoid sodium valproate and carbamazepine. For those using these medications, prenatal diagnosis is recommended. Ultrasound and amniocentesis with alpha-fetoprotein testing can provide information regarding the presence or absence of neural tube defects.Patients using sodium valproate should minimize excessive blood concentrations by dividing daily doses into 3-4 administrations or using controlled-release formulations.During the final month of pregnancy, oral vitamin K supplementation is recommended to prevent neonatal intracranial hemorrhage. 4. If seizures occur during the interictal period, immediately administer benzodiazepines or similar medications to control the episode. Continue antiepileptic drug therapy to prevent recurrence.