Biochemical and molecular teratology of fetal hydantoin syndrome

B. A. Buehler, V. Rao, R. H. Finnell

Research output: Contribution to journalReview article

35 Citations (Scopus)

Abstract

Animal and human research has clearly shown that anticonvulsants are teratogens and pose a risk for fetal malformations. In the case of dilantin it appears that fetal susceptibility correlates with the fetal level of the microsomal detoxifying enzyme epoxide hydrolase. The genetics of seizures in the parents does not predict the risk for fetal teratogenesis. The clinician must work with a mother who has seizures prior to conception to achieve the best control of seizures with a single anticonvulsant at the lowest effective dose to minimize the teratogenic potential, but even if this is done there is still a risk of fetal malformations and developmental delays. Each pregnancy in a woman on anticonvulsants is at risk, and appropriate counseling should be accomplished before conception so the family can make an informed decision. The exact risk of teratogenesis is lower than previously recorded. Dilantin poses approximately a 10% risk, tegretol less than 10%, and valproic acid causes a threefold increase in the risk of neural tube defects as well as an increased risk of other malformations. The positive aspect is that with good medical management and good prenatal care approximately 90% of infants exposed to anticonvulsants in utero will not show evidence of teratogenesis. Finally, it is important to stress that all pregnancies carry a 3% risk for a major birth defect independent of any exposures or genetic history.

Original languageEnglish (US)
Pages (from-to)741-748
Number of pages8
JournalNeurologic Clinics
Volume12
Issue number4
StatePublished - Jan 1 1994

Fingerprint

Teratology
Teratogenesis
Anticonvulsants
Seizures
Phenytoin
Teratogens
Epoxide Hydrolases
Fetal hydantoin syndrome
Pregnancy
Prenatal Care
Neural Tube Defects
Carbamazepine
Valproic Acid
Counseling
Parents
History
Mothers

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Buehler, B. A., Rao, V., & Finnell, R. H. (1994). Biochemical and molecular teratology of fetal hydantoin syndrome. Neurologic Clinics, 12(4), 741-748.

Biochemical and molecular teratology of fetal hydantoin syndrome. / Buehler, B. A.; Rao, V.; Finnell, R. H.

In: Neurologic Clinics, Vol. 12, No. 4, 01.01.1994, p. 741-748.

Research output: Contribution to journalReview article

Buehler, BA, Rao, V & Finnell, RH 1994, 'Biochemical and molecular teratology of fetal hydantoin syndrome', Neurologic Clinics, vol. 12, no. 4, pp. 741-748.
Buehler BA, Rao V, Finnell RH. Biochemical and molecular teratology of fetal hydantoin syndrome. Neurologic Clinics. 1994 Jan 1;12(4):741-748.
Buehler, B. A. ; Rao, V. ; Finnell, R. H. / Biochemical and molecular teratology of fetal hydantoin syndrome. In: Neurologic Clinics. 1994 ; Vol. 12, No. 4. pp. 741-748.
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