Outcome of Epileptic Pregnancy: Neonatal Hemorrhage due to Anticonvulsant Treatment of Mothers during Pregnancy

Abstract

Sixteen neonates were born from epileptic women under anticonvulsant treatment. Most of the mothers were administered phenobarbital and phenytoin. Although no congenital anomaly was observed, 2 neonates showed hemorrhage and one died 25 hours after birth from profuse intra‐abdominal hemorrhage derived from ruptured subcapsular hematoma of the liver. The cord blood concentration of anticonvulsants correlated well with both maternal daily dose and maternal blood concentration. The ratio of cord blood to maternal blood concentration was approximately 1: 1 with phenobarbital and phenytoin. In the 2 neonates with hemorrhage, both the maternal dose and the cord blood concentration were relatively low. The cord blood of neonates born from an epileptic mother treated with anticonvulsants (especially phenobarbital and phenytoin), should immediately be submitted to coagulation tests, even if maternal daily dose or blood concentration of the drug is low. Such infants should be closely observed and be transfused with fresh frozen plasma, if bleeding is detected.