Robertson I G
Clin Obstet Gynaecol. 1986 Jun;13(2):365-84.
In women with epilepsy, seizure control during pregnancy can be improved by maintaining the serum anticonvulsant drug concentration within the therapeutic range. Treatment with one anticonvulsant drug plus folic acid supplementation 5 mg per day seems appropriate in most cases. This should be achieved before conception whenever possible. No anticonvulsant drug seems free of teratogenic risk. With the commonly used anticonvulsant drugs-phenytoin, phenobarbitone, carbamazepine and sodium valproate-the risk is relatively low and represents less potential harm to the fetus than might occur with uncontrolled seizures.
对于患有癫痫的女性,在孕期通过将血清抗惊厥药物浓度维持在治疗范围内可改善癫痫发作的控制情况。在大多数情况下,使用一种抗惊厥药物加每天补充5毫克叶酸似乎是合适的。只要有可能,应在受孕前实现这一点。似乎没有一种抗惊厥药物不存在致畸风险。对于常用的抗惊厥药物——苯妥英、苯巴比妥、卡马西平和丙戊酸钠——风险相对较低,且相较于癫痫发作未得到控制时对胎儿造成的潜在危害要小。