[Epilepsy and pregnancy].

One out of 200 pregnant women suffers from epilepsy. Pregnancy and epileptic disease or its medical treatment, respectively, do interfere, as on the one hand serum concentration of antiepileptic drugs can severely be altered during pregnancy. On the other hand these drugs cause a fetal malformation rate 2-3 times higher than in an average population. These facts demand an interdisciplinary cooperation between neurologists, pediatricians and obstetricians. Preconceptional advice should lead to a preventive folic acid medication and information about the higher risk for preterm delivery, intrauterine growth retardation or fetal death as sequelae of epileptic attacks. In antepartal investigations the emphasis should be on the sonographic diagnosis of fetal malformations and on regular control of serum concentration of antiepileptic drugs. During labor a tight fetal monitoring is obligatory. There is no indication for a primary cesarean section. The risk of neonatal hemorrhage due to a lack of vitamin K is reduced by prophylactic medication. Under optimal conditions about 90% of pregnancies and deliveries will be uncomplicated. During puerperium serum levels of antiepileptics should be controlled again. Breastfeeding is possible.