Case Report
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Fetal Left Acheiria in Levetiracetam Use During Pregnancy: A Case Report

Year 2022, Volume: 8 Issue: 3, 360 - 363, 01.09.2022
https://doi.org/10.53394/akd.1059584

Abstract

Abstract:
Epilepsy is one of the common chronic disorders seen in women of reproductive age. There are serious maternal and fetal risks of having an epileptic seizure, so it is necessary to continue treatment during pregnancy. Congenital malformation (CM) rates increase especially with first-generation antiepileptic use. Levetiracetam (LEV) is a second generation antiepileptic with relatively few teratogenic side effects. Although there are publications about CM in pregnant women using LEV, no malformation specific to this drug has been reported. We report a case using LEV during pregnancy and left hand absent (acheiria) in the fetus.
Keywords: Congenital malformation, Fetal acheiria, Levetiracetam, Antiepileptic drug

References

  • 1. MacDonald SC, Bateman BT, McElrath TF, Hernández-Díaz S: Mortality and Morbidity During Delivery Hospitalization Among Pregnant Women With Epilepsy in the United States. JAMA neurology 2015; 72(9):981-988.
  • 2. Mawhinney E, Craig J, Morrow J, Russell A, Smithson WH, Parsons L, Morrison PJ, Liggan B, Irwin B, Delanty N, Hunt, S.J.: Levetiracetam in pregnancy: results from the UK and Ireland epilepsy and pregnancy registers. Neurology 2013; 80(4):400-405.
  • 3. Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E, Sabers A, Thomas SV, Vajda F: Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. The Lancet Neurology 2018; 17(6):530-538.
  • 4. Campbell E, Kennedy F, Russell A, et al: Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers. Journal of neurology, neurosurgery, and psychiatry 2014; 85(9):1029-1034.
  • 5. Stoll C, Alembik Y, Dott B, Roth MP: Evaluation of prenatal diagnosis of limb reduction defects by a registry of congenital anomalies. Prenatal diagnosis 1994; 14(9):781-786.
  • 6. Holmes LB, Harvey EA, Coull BA, Huntington KB, Khoshbin S, Hayes AM, Ryan LM: The teratogenicity of anticonvulsant drugs. The New England journal of medicine 2001; 344(15):1132-1138.
  • 7. Battino D, Tomson T, Bonizzoni E, Craig J, Lindhout D, Sabers A, Perucca E, Vajda F: Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia 2013; 54(9):1621-1627.
  • 8. Mawer G, Briggs M, Baker GA, Bromley R, Coyle H, Eatock J, Kerr L, Kini U, Kuzmyshcheva L, Lucas SB, Wyatt, L, Clayton-Smith, J: Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study. Seizure 2010; 19(2):112-119.
  • 9. Vajda FJE, Graham JE, Hitchcock AA, Lander CM, O'Brien TJ, Eadie MJ: Antiepileptic drugs and foetal malformation: analysis of 20 years of data in a pregnancy register. Seizure 2019; 65:6-11.
  • 10. Blotière PO, Raguideau F, Weill A, Elefant E, Perthus I, Goulet V, Rouget F, Zureik M, Coste J, Dray-Spira R: Risks of 23 specific malformations associated with prenatal exposure to 10 antiepileptic drugs. Neurology 2019; 93(2):e167-e180.
  • 11. Meador KJ, Loring DW: Developmental effects of antiepileptic drugs and the need for improved regulations. Neurology 2016; 86(3):297-306.
  • 12. Chaudhry SA, Jong G, Koren G: The fetal safety of Levetiracetam: a systematic review. Reproductive toxicology (Elmsford, NY) 2014; 46:40-45.
  • 13. Isoherranen N, Spiegelstein O, Bialer M, Zhang J,et al: Developmental outcome of levetiracetam, its major metabolite in humans, 2-pyrrolidinone N-butyric acid, and its enantiomer (R)-alpha-ethyl-oxo-pyrrolidine acetamide in a mouse model of teratogenicity. Epilepsia 2003; 44(10):1280-1288.
  • 14. Gramellini D, Fieni S, Vadora E: Prenatal diagnosis of isolated limb defects: an updated review. Fetal diagnosis and therapy 2005; 20(2):96-101.

Levetirasetam Kullanan Gebede Fetal Sol El Yokluğu: Olgu Sunumu

Year 2022, Volume: 8 Issue: 3, 360 - 363, 01.09.2022
https://doi.org/10.53394/akd.1059584

Abstract

Öz:
Epilepsi, üreme çağındaki kadınlarda görülen yaygın kronik hastalıklardan biridir. Epileptik nöbet geçirmenin ciddi maternal ve fetal riskleri vardır, bu nedenle gebelikte tedaviye devam etmek gerekir. Konjenital malformasyon (KM) oranları özellikle birinci kuşak antiepileptik kullanımı ile artmaktadır. Levetirasetam (LEV) ise ikinci kuşak antiepileptik olup, teratojenik yan etkileri daha azdır. LEV kullanan gebede KM ile ilgili yayınlar olmasına rağmen, bu ilaca özgü herhangi bir malformasyon bildirilmemiştir. Biz gebeliği boyunca LEV kullanan ve fetüste sol el yokluğu (acheiria) izlenen bir vakayı bildirmekteyiz.
Anahtar Kelimeler:Konjenital malformasyon, Fetal el yokluğu, Levetirasetam, Antiepileptik ilaç

References

  • 1. MacDonald SC, Bateman BT, McElrath TF, Hernández-Díaz S: Mortality and Morbidity During Delivery Hospitalization Among Pregnant Women With Epilepsy in the United States. JAMA neurology 2015; 72(9):981-988.
  • 2. Mawhinney E, Craig J, Morrow J, Russell A, Smithson WH, Parsons L, Morrison PJ, Liggan B, Irwin B, Delanty N, Hunt, S.J.: Levetiracetam in pregnancy: results from the UK and Ireland epilepsy and pregnancy registers. Neurology 2013; 80(4):400-405.
  • 3. Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E, Sabers A, Thomas SV, Vajda F: Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. The Lancet Neurology 2018; 17(6):530-538.
  • 4. Campbell E, Kennedy F, Russell A, et al: Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers. Journal of neurology, neurosurgery, and psychiatry 2014; 85(9):1029-1034.
  • 5. Stoll C, Alembik Y, Dott B, Roth MP: Evaluation of prenatal diagnosis of limb reduction defects by a registry of congenital anomalies. Prenatal diagnosis 1994; 14(9):781-786.
  • 6. Holmes LB, Harvey EA, Coull BA, Huntington KB, Khoshbin S, Hayes AM, Ryan LM: The teratogenicity of anticonvulsant drugs. The New England journal of medicine 2001; 344(15):1132-1138.
  • 7. Battino D, Tomson T, Bonizzoni E, Craig J, Lindhout D, Sabers A, Perucca E, Vajda F: Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia 2013; 54(9):1621-1627.
  • 8. Mawer G, Briggs M, Baker GA, Bromley R, Coyle H, Eatock J, Kerr L, Kini U, Kuzmyshcheva L, Lucas SB, Wyatt, L, Clayton-Smith, J: Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study. Seizure 2010; 19(2):112-119.
  • 9. Vajda FJE, Graham JE, Hitchcock AA, Lander CM, O'Brien TJ, Eadie MJ: Antiepileptic drugs and foetal malformation: analysis of 20 years of data in a pregnancy register. Seizure 2019; 65:6-11.
  • 10. Blotière PO, Raguideau F, Weill A, Elefant E, Perthus I, Goulet V, Rouget F, Zureik M, Coste J, Dray-Spira R: Risks of 23 specific malformations associated with prenatal exposure to 10 antiepileptic drugs. Neurology 2019; 93(2):e167-e180.
  • 11. Meador KJ, Loring DW: Developmental effects of antiepileptic drugs and the need for improved regulations. Neurology 2016; 86(3):297-306.
  • 12. Chaudhry SA, Jong G, Koren G: The fetal safety of Levetiracetam: a systematic review. Reproductive toxicology (Elmsford, NY) 2014; 46:40-45.
  • 13. Isoherranen N, Spiegelstein O, Bialer M, Zhang J,et al: Developmental outcome of levetiracetam, its major metabolite in humans, 2-pyrrolidinone N-butyric acid, and its enantiomer (R)-alpha-ethyl-oxo-pyrrolidine acetamide in a mouse model of teratogenicity. Epilepsia 2003; 44(10):1280-1288.
  • 14. Gramellini D, Fieni S, Vadora E: Prenatal diagnosis of isolated limb defects: an updated review. Fetal diagnosis and therapy 2005; 20(2):96-101.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Case Report
Authors

Hülya Kandemir This is me 0000-0001-8218-1893

Cem Yaşar Sanhal This is me 0000-0003-0007-5769

Mehmet Sakıncı This is me 0000-0001-5074-0005

Publication Date September 1, 2022
Submission Date January 7, 2021
Published in Issue Year 2022 Volume: 8 Issue: 3

Cite

Vancouver Kandemir H, Sanhal CY, Sakıncı M. Levetirasetam Kullanan Gebede Fetal Sol El Yokluğu: Olgu Sunumu. Akd Med J. 2022;8(3):360-3.