7. 1-3.8% (VPA) 0.5-1.0% (CBZ) 0.06% Neural tube defect 1.7% 0.7% Urogenital defect 1.4% 0.15% Cleft lip /palate 1.5-2.0% 0.5% Congenital heart Infants of women who have epilepsy General population
8.
9.
10.
11. 47-70 Cleft maxillary palate 36 Cleft lip Face 42 VSD Heart 28 days Neural tube defect CNS Postconceptional age malformations Tissue Timing and developmental pathology of certain malformations
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14.
15. Altered free fraction; increased availability of drug for hepatic extraction Decreased maternal alb Altered systemic absorption and hepatic elimination Altered cytochrome P 450 activity ^renal clearance of unchanged drug ^Renal blood flow and GFR ^hepatic blood flow leading to ^ elimination ^cardiac output Decreased elimination of lipid soluble drugs ^Fat stores Altered drug distribution ^total body water, extracellular fluid Consequences Parameter Physiologic changes during pregnancy; effects on drug disposition