Foetal anticonvulsant syndrome (FACS) is a condition that affects some babies exposed to antiseizure medicines (ASMs) in the womb.1 The most implicated medication is sodium valproate (Epilim), which carries a higher risk, especially when taken early in pregnancy or at high doses. Other ASMs linked to FACS include topiramate (used as a second-line migraine preventer), phenobarbitone, phenytoin, and carbamazepine.
Potential harms include spina bifida, cleft palate, and heart defects, as well as learning and behavioural difficulties, including autism spectrum disorder. Babies exposed to sodium valproate may be eight times more likely to need extra help at school.
If you have patients taking ASMs, discuss contraceptives, annual reviews, and planning six to twelve months ahead for pregnancy. Get advice to minimise risks. Stopping medications abruptly can lead to seizures, which may be even more harmful to both mother and baby.
This Gem was approved by Dr Jin Russell, Clinical Chief Advisor – Child and Youth, Ministry of Health.
