Zwangerschap en anti-epileptica; de waarde van prenataal echoscopisch onderzoek voor het opsporen van aangeboren afwijkingen

-A total of 162 pregnant women using anticonvulsant drugs were examined for foetal congenital defects over a period of five years. In 138 of them, AFP levels were determined in amniotic fluid at 16 weeks of gestation to rule out spina bifida. In all women an ultrasound scan for foetal anomalies was performed between 18 and 20 weeks of gestation. AFP levels were always within the normal range, neonatal examination revealed no spina bifida. However, in seven newborns, the presence of single or multiple structural defects other than spina bifida was established. Apart from severe hydrocephaly, hypospadias and radius aplasia, the anomalies were too small to be visualized by ultrasound.

Pregnant women using anticonvulsant drugs should be informed about the limitations of ultrasound in the early detection of structural defects attributed to the use of these agents.