Epilepsy in Pregnancy (Green-top Guideline No. 68) Skip to main content

Epilepsy in Pregnancy (Green-top Guideline No. 68)

Published: 20/06/2016

This is the first edition of this guideline. 

It has been produced by the RCOG and endorsed by the following organisations: Association of British Neurologists, Epilepsy Action, Royal College of General Practitioners, Royal College of Midwives and Royal College of Physicians.


Update May 2018: The CMDh recently endorsed a strengthened regulatory position on valproate. We welcome this action to reduce the risk of physical and developmental problems in children born to mothers who have taken valproate during pregnancy.  This guideline recommends that exposure to sodium valproate and other anti-epileptic drugs should be minimised by changing the medication prior to conception, as recommended by an epilepsy specialist after a careful evaluation of the potential risks and benefits.

Read about the April 2018 announcement by the MHRA on valproate medicines.


This guideline summarises the evidence on maternal and fetal outcomes in women with epilepsy (WWE). It provides recommendations on the care of WWE during the prepregnancy, antepartum, intrapartum and postpartum periods.

The guideline does not cover the methods of diagnosis of epilepsy, detailed categorisation of seizures or strategies for the management of epilepsy. These are addressed in detail in the National Institute for Health and Care Excellence clinical guideline and Scottish Intercollegiate Guidelines Network publication.


Declaration of interests (guideline developers)

Professor S Thangaratinam MRCOG, London: Professor Thangaratinam has received a study grant from Barts Charity. She is Project Coordinating Lead for the EMPiRE trial, which is funded by the National Institute for Health Research Health Technology Assessment programme. She is also an Executive Board member on the Maternal Medicine Clinical Study Group; the group is sponsored by MacDonald UK Obstetric Medicine Society and British Maternal and Fetal Medicine Society. 

Dr F Fong MRCOG, London: None declared.

Dr D McCorry MD, FRCP, University Hospital Birmingham NHS Trust, Birmingham: Dr McCorry has received consulting fees or honoraria for advisory board meetings, and payment for lectures from both Eisai and UCB.

Mr AM Pirie FRCOG, Birmingham: Mr Pirie is National Obstetric Lead for the EMPiRE trial, which is funded by the National Institute for Health Research Health Technology Assessment programme. He has received payment for a commissioned textbook chapter, and fees for expert testimony.

Dr M Bagary PhD, MRCPsych, Birmingham: Dr Bagary has received consulting fees or honoraria for attending advisory boards, commercial support for attending conferences, and payment for lectures from both Eisai and UCB.

Mrs L Greenhill, Birmingham: None declared.