The use of acetazolamide in idiopathic intracranial hypertension during pregnancy

PURPOSE: To describe the pregnancy outcomes after the use of acetazolamide in pregnant patients with idiopathic intracranial hypertension (IIH). DESIGN: Observational case series. METHODS: SETTING: Two tertiary care academic neuro, ophthalmology units. PATIENT POPULATION: Patients with IIH treated with acetazolamide. OBSERVATION PROCEDURE: Documentation of pregnancy outcome. MAIN OUTCOME MEASURES: Normal pregnancy, fetal loss, or congenital malformation. RESULTS: Twelve patients were treated with acetazolamide for IIH during pregnancy, and there were no adverse pregnancy outcomes. A critical review of the English language literature on the subject failed to demonstrate any convincing evidence for any adverse effect on pregnancy for acetazolamide. CONCLUSIONS: Acetazolamide at high doses may produce birth defects in animals, but there is little clinical or experimental evidence to support any adverse effect of the drug on pregnancy outcomes in humans. If the clinical situation warrants the use of acetazolamide in IIH, then the drug probably can be offered after appropriate informed consent. (c) 2005 by Elsevier Inc. All rights reserved.