Advice on sodium valproate use in women updated

Exposure to sodium valproate in utero is known to increase the risk of neural tube defects and other malformations | SCIENCE PHOTO LIBRARY
Exposure to sodium valproate in utero is known to increase the risk of neural tube defects and other malformations | SCIENCE PHOTO LIBRARY

Advice regarding the use of sodium valproate in women has been updated. The UK Teratology Information Service now states that:

  • All women of childbearing potential should be offered specialist neurological advice and given effective contraception.
  • If woman is planning pregnancy, treatment should be reassessed and high-dose folate supplementation provided if sodium valproate is continued.

When considering the risk-benefit balance, it is important to note that maternal seizures can also be associated with adverse foetal outcomes, including reduced placental perfusion, foetal anoxia and intrauterine death.

The updated guidance follows publication in The Lancet Neurology of data from the EURAP epilepsy and pregnancy registry, linking high maternal doses of antiepileptics to an increased risk of congenital malformations.

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