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

Summary: 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.

In 2018, the CMDh 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.

COVID disclaimer: This guideline was developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history: This is the first edition of this guideline; the second edition of this guideline is currently in development.

Developer declaration of interests: Available on request.



This page was last reviewed 20 June 2016.