Journal ArticleDOI
Trimethadione and human teratogenesis
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TLDR
The survey suggests that neither epileptic women as a group nor those taking antiepileptic drugs usually prescribed for adults have an obviously increased frequency of malformed children but that epileptic men and women taking trimethadione or paramethadion may constitute a special subgroup whose children do have an increase frequency of birth defects.Abstract:
A family is described in which four malformed children were born to a mother while she was taking trimethadione, an antiepileptic drug infrequently prescribed for adults. Following discontinuation of the drug, she had two normal children. This family led to a survey of all 278 epileptic women admitted to one hospital during the 23 years following the introduction of trimethadione for treatment of petit mal. Only eight women had ever taken it or its close congener paramethadione, and only three had taken it early in a pregnancy. Thus the outcomes of 14 pregnancies, during which the mothers took trimethadione or paramethadione early, have become known to the authors, those in the index family and those in three additional families ascertained through the survey. These pregnancies showed a high frequency of abnormality: eight children with developmental defects of various types, only three of whom have survived early infancy; one child with multiple hernias and juvenile, nonfamilial diabetes; and three spontaneous abortions. The survey suggests that neither epileptic women as a group nor those taking antiepileptic drugs usually prescribed for adults have an obviously increased frequency of malformed children but that epileptic women taking trimethadione or paramethadione may constitute a special subgroup whose children do have an increased frequency of birth defects. The small number of observations possible at a single institution, although suggestive, precludes a firm opinion as to the possible role as human teratogens of the oxazolidine-2,4-diones.read more
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Journal ArticleDOI
Pregnancy outcomes in women with epilepsy: A systematic review and meta-analysis of published pregnancy registries and cohorts
TL;DR: The overall incidence of CMs in children born of WWE is approximately threefold that of healthy women, and the risk is elevated for all AED monotherapy and further elevated for AED polytherapy compared to women without epilepsy.
Journal ArticleDOI
Multi‐institutional Study on the Teratogenicity and Fetal Toxicity of Antiepileptic Drugs: A Report of a Collaborative Study Group in Japan
Yoshibumi Nakane,Teruo Okuma,Ryo Takahashi,Yorio Sato,Toyoji Wada,Tokijiro Sato,Yutaka Fukushima,Hisashi Kumashiro,Tsuneo Ono,Takeo Takahashi,Yasunori Aoki,Hajime Kazamatsuri,Masaaki Inami,Sumiya Komai,Masakazu Seino,Masako Miyakoshi,Takashi Tanimura,Hidebumi Hazama,Ryuzo Kawahara,Saburo Otsuki,Kiyoshi Hosokawa,Kazutoyo Inanaga,Yoichi Nakazawa,Koichi Yamamoto +23 more
TL;DR: It is presumed on the basis of the results of analysis of the data that a combination of more than three drugs and a daily dose greater than a certain minimal level is likely to produce malformed infants.
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Consensus guidelines: preconception counseling, management, and care of the pregnant woman with epilepsy.
TL;DR: All women with epilepsy who are of childbearing age should be advised (preferably before conception) that the incidence of malformations in infants of mothers with epilepsyWho are treated with antiepileptic drugs (AEDs) is two or three times that of infants of Mothers without epilepsy.
Journal ArticleDOI
Parental epilepsy, anticonvulsant drugs, and reproductive outcome: epidemiologic and experimental findings spanning three decades; 2: Human studies.
TL;DR: Until adequate information is ascertained on just how antiepileptic drugs disrupt normal development, it will be difficult, if not impossible, to develop either alternative medications or treatment strategies that maximize clinical effectiveness without the risk of an adverse pregnancy outcome.
Journal ArticleDOI
Ethanol embryotoxicity: direct effects on mammalian embryos in vitro
TL;DR: Data suggest that the hypoplastic features of children born to chronically alcoholic mothers are due, at least in part, to a direct action of ethanol, which causes reduced embryonic cellular proliferation early in gestation.
References
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Journal ArticleDOI
Anticonvulsant drugs and congenital abnormalities
TL;DR: Sir, I should be interested to know if your readers have seen babies with hare-lip, cleft palate, and certain other specific abnormalities born to mothers who receive regular anticonvulsant therapy.
Journal ArticleDOI
B. M. A. and the Green-Paper.
Book
The Dispensatory of the United States of America
TL;DR: It is now three-quarters of a century since the first edition of the United States Dispensatory was published and during that period it has grown from a volume of 1073 pages to one of nearly double that size, and simultaneously enhanced its reputation as a standard work of reference for matters pharmaceutical.