Resumen
OBJETIVO: para evaluar si un medicamento anticonvulsivante es recomendable para una mujer fértil _o en estado de embarazo_ que padece de epilepsia, se debe revisar todos los cambios que se dan durante la gestación y que influyen en la forma de tratar este tipo de pacientes.
DESARROLLO: se revisan los aspectos relacionados con la epilepsia en la mujer embarazada, la frecuencia, los riesgos para la madre y el feto, las causas de la dificultad para mantener el control de las crisis en la gestación, los factores que influyen sobre el paso de fármacos a través de la placenta, la seguridad de los anticonvulsivantes, los mecanismos de teratogenicidad, los cambios farmacocinéticos de los anticonvulsivantes inducidos por el embarazo y la identificación de problemas fetales por el uso de anticonvulsivantes en el embarazo.
CONCLUSIONES: el embarazo es generalmente seguro en la mujer con epilepsia, pero el apoyo preconcepcional requiere de un trabajo cercano entre el neurólogo y el ginecólogo. El efecto adverso de los antiepilépticos sobre el embarazo se ha reconocido desde tiempo atrás pero el riesgo relativo de efectos fetales y maternos de cada anticonvulsivante aún no se ha definido.
Citas
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