Q: My friend who is a lady of 26 years is suffering from epileptic fits (grand mal) for the past 10 years. She is under medication (encorate chrono). She is pregnant now (61 days); her blood group is O negative and husband is O positive. The babys growth is fine. Gynaecologist is advising not to take drugs for epilepsy but neurologist told strictly not to leave the drug. Is there any complication during pregnancy regarding this drug?

A:Great caution has to be observed while using anti-epileptic drugs during pregnancy since there is a possibility of malformation of baby. However appropriate drug MUST be given. It is most dangerous to stop taking medication. The drug of first choice during pregnancy is phenytoin (Brand name: Epsolin) or carbamazepine (Brand names: Mazetol or Tegrital). Folic acid 5 mg must be given daily to minimize side effects. At 16 weeks, alpha-fetoprotein should be measured to make sure that there is no problem. An ultrasound is also necessary after 3 months. Encorate Chrono (sodium valproate) is to be avoided due to danger of neural tube defect in the baby. These are tried-and-tested drugs. Newer drugs should not be used because their risks on baby are unknown.