Search
Disclaimer: Talking about seizures/status that is NOT due to eclampsia
- Propofol (Class B) -- though not recommended for obstetric use by manufacturer
- Benzodiazepines (Class D) -- mostly due to fetal withdrawal syndrome, but some teratogenicity to prolonged exposure inconsistent in literature
- Ketamine (No FDA class assigned but likely Class B Austrailia equivalent)
- Levetiracetam (Class C) -- no clear evidence of major fetal malformations in humans
- Phenytoin, phenobarbitol, carbemazepine, valproic acid and most other common AEDs (Class D due to teratogenicity)
TAKE HOME: While no AEDs are completely safe in pregnancy, treatment and stabilization of maternal status epilepticus is paramount for fetal health. Involve neurology/epileptology and OB/maternal-fetal medicine.
References
1. Hern ndez-D az S, et al; North American AED Pregnancy Registry; North American AED Pregnancy Registry. Comparative safety of antiepileptic drugs during pregnancy. Neurology. 2012 May 22;78(21):1692-9.
2. McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol. 1994 Nov-Dec;8(6):461-75.
3. Lexicomp online accessed via uptodate.com.