Fetal anticonvulsant syndrome

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By Yu-tze Ng MD

Fetal anticonvulsant syndrome is also known as or subsumes Fetal hydantoin syndrome, Fetal phenobarbital syndrome, Fetal primidone syndrome, Fetal trimethadione syndrome, and Fetal valproate syndrome. -ed

Many attempts have been made to characterize the different patterns of malformations that are typical or diagnostic for in utero antiepileptic drug exposure. It is now generally accepted that many of the conventional anticonvulsant drugs, with the possible exception of valproic acid, may produce a similar pattern of malformations. Although there is anecdotal belief that the newer antiepileptic drugs may be less teratogenic, recent studies of the United States, North American, and European Birth Registries may prove that this is not the case. Although early studies with regard to lamotrigine suggested that its associated teratogenic risks may be extremely low, the latest data from the North American Birth Registry do not reach the same conclusion. With the exception of valproate having consistently high teratogenic rates, the data on the newer antiepileptic drugs remain unclear. In this clinical article, Dr. Yu-tze Ng, and colleagues discuss the clinical manifestations, pathogenesis, and epidemiology of fetal anticonvulsant syndrome.