Epilepsy in pregnancy

Summary of changes 

Medicines

  • Removed oral vitamin K for last 4 weeks of pregnancy. If taking enzyme-inducing antiepileptics — give vitamin K oral once a day for last 4 weeks of pregnancy (from 36 weeks) – 20mg as no evidence for Vitamin K use
  • Lamotrigine and levetiracetam recommended as safest antiepileptic medicine
  • eTG recommends 5mg folic acid 3months before and after conception

Primary references

  1. Ahmed R, Apen K and Endean C (2014) 'Epilepsy in pregnancy – a collaborative team effort of obstetricians, neurologists and primary care physicians for a successful outcome', Australian Family Physician, 43(3):112-116.

  2. American Academy of Neurology (2016) 'Appendix C: AAN Summary of Evidence-Based Guideline for Clinicians: Management Issues for Women With Epilepsy-Focus on Pregnancy: Vitamin K, Folic Acid, Blood Levels, and Breastfeeding', Continuum (Minneap Minn), 22(1 Epilepsy):285-6, doi:10.1212/01.CON.0000480843.89012.5b

  3. Guidelines Committee of the Royal College of Obstetricians and Gynaecologists (2018) Epilepsy in Pregnancy (Green-top Guideline No. 68), accessed 5 April 2022.

  4. Pennell PB and McElrath T (2021) Management of epilepsy during preconception, pregnancy, and the postpartum period, UptoDate, accessed 1 August 2021.

  5. Pennell PB and McElrath T (2021) Risks associated with epilepsy during pregnancy and postpartum period, UpToDate, accessed 1 August 2021.

  6. South Australian Maternal, Neonatal and Gynaecology Community of Practice (2019) Epilepsy and pregnancy management, SA Perinatal Practice Guidelines, accessed 4 April 2022.