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Carbamazepine in two pregnancies.

2 patients with epilepsy in pregnancy are described. Both received carbamazepine prior to conception, and during the greater portion of the first trimester. Both had partial and generalised epilepsy of late onset. Case 1 resulted in stillbirth at 25 weeks' gestation. The malformations included closely set eyes, atresia of multiple hollow viscera, and non-fusion of the mandible without hare lip or cleft palate. A possible interaction with a compound analgesic is discussed. Case 2 resulted in a normal baby. The literature, although favouring carbamazepine in pregnancy, is not yet sufficiently decisive to indicate a clear preference between no treatment and carbamazepine with carefully monitored serum levels for epilepsy in pregnancy. This study emphasises the need for continued pooling of data, and for added caution when there is a history of fetal malformation or obstetric problems. The teratogenicity of carbamazepine is neither confirmed nor denied by this limited study.