Special attention should be given to seizure control in women of childbearing age to minimize the effects of antiepileptic drugs on the fetus based on effective seizure control. (i) Teratogenicity of antiepileptic drugs Clinical observations have found that certain AEDs are associated with specific types of abnormalities. Among the traditional antiepileptic drugs, phenytoin sodium can cause the so-called “fetal phenytoin sodium syndrome”, including craniofacial anomalies (e.g., medial canthus, strabismus, wide-spaced eyes, ear anomalies, large mouth and protruding lips, cleft lip and palate, low nasal bridge, upturned nose, short neck, etc.), limb defects (finger and nail hypoplasia), heart defects, in utero developmental delay, microcephaly The incidence of this syndrome can be as high as 11%, including delayed development, microcephaly and mental retardation. However, the syndrome is also seen in patients taking other antiepileptic drugs (e.g., carbamazepine, paracetamol, phenobarbital, sodium valproate) and is therefore collectively referred to as “fetal antiepileptic drug syndrome”. Sodium valproate causes the most common fetal anomalies, including neural tube defects (spina bifida), mental retardation, behavioral disorders, hypospadias, partial agenesis of the corpus callosum, and ventricular septal dysplasia. Data from the North American Antiepileptic Drug Pregnancy Registry showed that 5 infants had significant malformations (6.5%) in 77 pregnant women treated with phenobarbital monotherapy compared with 1.62% in the general population; the rate of significant defects was 10.7% in 149 pregnant women treated with sodium valproate monotherapy and 2.8% in pregnant women taking other antiepileptic drugs compared with 1.6% in the general population control group. A Danish multicenter prospective study reported an overall infant malformation rate of 3.1%, with lamotrigine at 2% and valproate at 6.7%. Therefore, national guidelines suggest caution in the use of VPA in pregnancy in women of childbearing age. Newer antiepileptic drugs, including lamotrigine, gabapentin, topiramate, felbamate, tiagarpine, oxcarbazepine, aminoglutethimide, zonisamide, and levetiracetam, have good pharmacokinetics, low protein binding, and only topiramate and oxcarbazepine have mild cytochrome P450 enzyme induction and do not produce aromatic oxidative metabolites. However, the conclusion of their teratogenicity needs to be confirmed by the data of a large sample of prospective studies. Therefore, the US Food and Drug Administration has classified it as Class C in the pregnancy safety classification. (The following measures can be taken: 1. If the epilepsy has been controlled before conception and has been seizure-free for 2-5 years, or if the number of seizures is minimal, consider stopping the drug before conception. If antiepileptic drugs are still needed for seizure control during pregnancy, the lowest amount of a single drug should be chosen according to the type of seizure. If antiepileptic drugs are to be changed or discontinued, this must be done at least 6 months before conception. 3. Avoid the combined application of multiple drugs, try to avoid high serum concentrations, and preferably take them 3-4 times a day or use controlled-release tablets. 4.Take 2.5-5mg of folic acid daily for 3 months before and after conception to reduce or avoid fetal malformation. 5.In the last 1 month of pregnancy, pregnant women take vitamin K 10-20m/d orally for the benefit of the baby, but care should be taken to prevent venous thrombosis in the mother. 6. Vitamin K 1mg should be injected subcutaneously immediately after birth to prevent intracranial hemorrhage in newborns. 7. Ultrasound examination of the fetus should be performed regularly during pregnancy. For pregnant women with conditions, serum alpha-fetoprotein level monitoring and ultrasonography should be performed within 14-18 weeks of gestation (95% of fetal neural tube defects can be detected), and amniocentesis should be performed for diagnosis if necessary. High alert for neural tube defects when maternal age >35 years, or ultrasound findings are suspicious, or serum alpha-fetoprotein levels are abnormal. 8. If seizures occur during delivery, benzodiazepines should be given immediately to control the seizures and antiepileptic drugs should be continued to prevent recurrence of seizures. 9. For non-convulsive seizures with daily seizures and generalized tonic-clonic seizures with weekly seizures, the dose of antiepileptic drugs should be adjusted or increased as appropriate during the last 3 months of pregnancy to avoid seizures during delivery.