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-In general, considered teratogenic
--> 5-10% with a single medication
--> Risk doubles if exposure to two or more medications
-Fetal Anticonvulsant Syndromes (FACS)- dysmorphology, developmental delay, neural tube defects, genitourinary anomalies, limb and heart defects
-Folic acid antagonists; recommend folic acid supplementation
-Recommend vitamin K treatment near term (newborn hemorrhagic disease)
-In 1/3 of cases, seizure activity increases in pregnancy
-Difficulty in balancing teratogenic risks of medications with risks of seizures during pregnancy
*Optimal seizure control is imperative during pregnancy despite teratogenic risks*
-Patients should be encouraged to take meds under care by neurology, maternal-fetal-management specialist