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METABOLISM OF DIPHENYLHYDANTOIN (PHENYTOIN) DURING PREGNANCY
Author(s) -
Landon M. J.,
Kirkley Maureen
Publication year - 1979
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1979.tb10579.x
Subject(s) - phenytoin , pregnancy , metabolite , excretion , medicine , microgram , endocrinology , urinary system , urine , plasma concentration , gestational age , physiology , metabolism , epilepsy , chemistry , biology , biochemistry , psychiatry , in vitro , genetics
Summary Plasma levels of diphenylhydantoin (DPH) and the 24 hour urinary excretion of both DPH and its major metabolite 5‐(p‐hydroxyphenyl)‐phenylhydantoin (HPPH) were measured serially during pregnancy in a group of five unselected epileptic patients. Plasma DPH levels fell and on average were some 40 per cent lower at term than they had been in early pregnancy. With one exception, the patients were well controlled during pregnancy but two patients who regularly had plasma DPH levels below 10 μ/ml both suffered seizures in the puerperium. There was no convincing change in the excretion of either DPH or HPPH which together accounted for less than half the administered dose. Gestational length exceeded 41 weeks in 4 of the 5 patients studied but all were delivered of normal healthy infants, of average birthweight, with no congenital defects or clotting disorders.