Bruni J, Willmore L J
Can J Neurol Sci. 1979 Aug;6(3):345-9. doi: 10.1017/s0317167100023982.
The management of the pregnant epileptic requires close cooperation between the neurologist and obstetrician. To prevent complications, knowledge is required about the natural history of epilepsy during pregnancy, the possible teratogenic effects of antiepileptic drugs, and changes in their absorption, biotransformation, and excretion. Close plasma antiepileptic drug monitoring is required because of the change in the handling of antiepileptic drugs during pregnancy. The treatment of status epilepticus with intravenous phenytoin is effective. Drug interactions which may lead to toxic plasma levels of some drugs and subtherapeutic plasma levels of others should be anticipated. The risk of problems resulting from antiepileptic drug therapy during pregnancy appears to be minor, provided that proper medical supervision is available. Newer antiepileptic drugs should not be administered to the pregnant epileptic until their safety in pregnancy is fully established.
妊娠癫痫患者的管理需要神经科医生和产科医生密切合作。为预防并发症，需要了解癫痫在孕期的自然病史、抗癫痫药物可能的致畸作用及其吸收、生物转化和排泄的变化。由于孕期抗癫痫药物处置的改变，需要密切监测血浆抗癫痫药物水平。静脉注射苯妥英钠治疗癫痫持续状态有效。应预料到可能导致某些药物血浆中毒水平和其他药物血浆治疗水平不足的药物相互作用。只要有适当的医疗监督，孕期抗癫痫药物治疗导致问题的风险似乎较小。在新型抗癫痫药物在孕期的安全性完全确定之前，不应给予妊娠癫痫患者使用。
