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Abstract Sum””’?’ and Conclusion SUMMARY AND CONCLUSION The major problem in the management of epileptic patients during pregnancy is the possibility that certain antiepileptic drugs may induce fetal abnormalities. However, controversy still exists regarding the potential teratogenicity of these drugs. The present work was carried out to evaluate the teratogenic potential of some commonly used antiepileptic drugs, namely phenytoin and clonazepam. This was carried out through a prospective study on the experimental animal albino rat. Seventy five adult albino rats ranging in the weight from 180 to 200 gm were used in this prospective study. There were 50 virgin females and 25 males. They were kept under good nutritional and general conditions. The animals were divided into 3 main groups. The frist one was used as control. It consisted of 1 0 females mated with 5 males. Each of the other 2 groups consisted of 20 females mated with 10 males. For each group one antiepileptic drug was given intramuscularly in its therapeutic dose. The first subgroup was given phenytoin sodium on days 7 to 15 of gest:c>!ion. The second subgroup was given clonazepam on days 7 to 15 of gesrarion. PageNo.l47 Summary and Conclusion Accurate evaluation of the experimental data was conducted as follows. 1- The pregnant rats were sacrificed by cervical dislocation 12 to 24 hours before the expected day of delivery. Foetuses were taken immediately after being delivered by caeserian section. 2- The number of foetuses whether alive or dead and their exact positions in the uterine horns were carefully noted. The fetuses examined for external abnormalities, examined for cross sectional abnormalities, skeletal, histological, .. etc. 3- Counting the number of the metria! glands which indicate the original implantation sites and determine whether resorption had occured or not. Analysis of the data obtained revealed the following. - Administration of phenytoin sodium to female rats during pregnancy affected markedely the offspring both the mean number of offspring per mother at birth and their mean birth weight were reduced. On the other hand, resorption rate and the mean fetal length (crown- rump I em) were also reduced. Some morphological and skeletal abnormalities were detected among the offsprings and in addition histopathological changes were detected in their internal organs. Lastly cross sectional abnormalities could be demonstrated. Administration of clonazepam to female rats during pregnancy did not lead to the appearance of morphological PageNo./48 Summary and Conclusion Accurate evaluation of the experimental data was conducted as follows. 1- The pregnant rats were sacrificed by cervical dislocation 12 to 24 hours before the expected day of delivery. Foetuses were taken immediately after being delivered by caesarian section. 2- The number of foetuses whether alive or dead and their exact positions in the uterine horns were carefully noted. The fetuses examined for external abnormalities, examined for cross sectional abnormalities, skeletal, histological, .. etc. 3- Counting the number of the metria! glands which indicate the original implantation sites and determine whether resorption had occured or not . Analysis of the data obtained revealed the following. - Administration of phenytoin sodium to female rats during pregnancy affected markedely the offspring both the mean number of offspring per mother at birth and their mean birth weight were reduced. On the other hand, resorption rate and the mean fetal length (crown - rump I em) were also reduced. Some morphological and skeletal abnormalities were detected among the offsprings and in addition histopathological changes were detected in their internal organs. Lastly cross sectional abnormalities could be demonstrated. Administration of clonazepam to female rats during pregnancy did not lead to the appearance of morphological PageNo.148 Summary and Conclusion abnormalities among the offspring. The effects induced by clonazepam can be demonstrated. The mean number of offspring per mother in clonazepam treated rats was reduced and few histopathological changes were also detected among their internal organs. In conclusion phenytoin sodium found to be potentially teratogenic and embryotoxic in rats while clonazepam was found to be non teratogenic and its embryotoxic effects were limited. It is advisable, therefore to give clonazepam safely for treatment of epileptic patients during the childbearing period of life, and it can be given with least caution to pregnant women. On the other hand it is wise not to give phenytoin sodium to epileptic patients during the childbearing period of life due to the fact that it is teratogenic and embryotoxic. PageNo.J49 |