Epilepsy and pregnancy: maternal and fetal effects of phenytoin.

Patricia A. Waltman is an associate professor in the school of nursing and a neonatal nurse practitioner at the University of Mississippi Medical Center in Jackson, Miss. She coordinates and teaches in the neonatal nurse practitioner track in the graduate nursing program. tion of antiepileptic drugs by the mother. Status epilepticus is an immediate threat to both mother and fetus and significantly increases the risk of maternal and fetal death. The changes in frequency and duration of seizure activity during pregnancy appear to be due to increased hormonal production and physiological changes in pregnancy that alter or affect absorption of phenytoin. Increases in levels of estrogen and progesterone during pregnancy alter the seizure threshJoyce M. Brewer, RN, MSN,CS,CNM,CFNP Patricia A. Waltman, RN, EdD, CNNP