FETAL ANTICONVULSANT SYNDROME

Fetal anticonvulsant syndrome refers to the increased birth prevalence of major malformations and the characteristic pattern of minor anomalies identified in some children born to women who have taken antiepileptic drugs during pregnancy. The major malformations described most frequently are those common in the general population: congenital heart defects, cleft lip and/or cleft palate, and genitourinary abnormalities. There is an even greater birth prevalence of major malformations in children born to women taking two antiepileptic drugs, and the prevalence of major malformations continues to increase with each additional antiepileptic drug taken during pregnancy. Microcephaly or growth retardation may be observed, particularly when there has been exposure to multiple antiepileptic drugs. A characteristic pattern of minor anomalies may be observed, including midface and digital hypoplasia, and there is an increased incidence of hemorrhagic disease of the newborn in children exposed to phenytoin, carbamazepine, and phenobarbital., We discuss the evaluation and management of children exposed to antiepileptic drugs in utero. Keywords: fetal anticonvulsant syndrome; anticonvulsant embryopathy; fetal hydantoin syndrome; fetal valproate syndrome; carbamazepine embryopathy