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Management of women with epilepsy (WWE) during pregnancy requires balancing the risk of seizure recurrence against the adverse effect of anti-epileptic drugs (AED) on the women and foetus. The risk of major congenital malformations (MCMs) is relatively higher in AED exposed women (4% – 9%) as compared to the rate in the general population of women in the reproductive age in the United Kingdom (2.13%)[1] and other high income countries. . Hospital based MCM rate for unselected pregnancies in urban area in western India was 2.31% (1.71-3.10).