Epilepsy and Pregnancy

Pregnancy is a very exciting and eventful time in a woman’s life and if you are an epilepsy patient then your major concerns may be regarding the epilepsy medications that you are consuming. This is because the epilepsy medication may harm your unborn child. Epilepsy does not get any better or worse, when you get pregnant, but the risk of your pregnancy and labor getting complicated are much higher. A serious seizure during your pregnancy can be harmful to the unborn baby in your womb. The anti epilepsy medicines may also harm the unborn baby.

Women with epilepsy who want to have babies should go in for preconception counseling and coordinate with their health care provider. Women with epilepsy have a lower fertility rate and tend to generally have fewer children. A woman who has epilepsy and requires medicine should be informed before pregnancy that she has a 90 percent chance of having a healthy child. Their chances of having a mentally retarded child or a child with congenital malformations are three times higher than the average woman.

It is therefore advisable to discuss the risks involved in such pregnancies with your doctor, nurse or counselor, before conceiving. You could find out the risks and benefits of adjusting your epileptic medicines, if you are taking anti-epilepsy medicines. It is recommended to start taking 5mg of folic acid before conception and continue till 12th week of pregnancy. This dosage is higher than for normal women to avoid any spinal cord problem and defects to the fetus. You can discuss stopping your anti-epilepsy medicines if you have not had any seizures for quite some time before your conception. The chances of your child also having epilepsy can be discussed with your doctor.

The chances of getting a seizure during pregnancy are the same as when you are not pregnant. Depending upon the type of seizures you have during the epileptic attack, the unborn baby may be harmed. In partial, absence, myoclonic seizure, the seizure is not likely to harm the baby. In case of generalized tonic-clonic seizure, there are chances that a prolonged seizure may harm the unborn baby. Also such seizures do not occur during childbirth but precaution must be taken to have such deliveries at a hospital under medical supervision.

If during your pregnancy you are taking anti-epilepsy pills then there is an increased risk of giving birth to a baby with birth defects like congenital heart defects, neural tube defects (spina bifida), hypospadias (some defect in the penis) and facial defects. On an average 4 percent of epileptic women taking anti epilepsy medicines give birth to baby with birth defects. These risks also vary with the type of medicines being taken. Some medicines like sodium vaporate have a higher risk factor (7 percent) than others like lamotrigine (3percent) and hence they are not prescribed during pregnancy. If you are taking anti-epileptic medicines than it is recommended that you go in for high-resolution ultrasound scan at 18-20 weeks of pregnancy. This scan helps to screen for birth defects in the fetus. This scan can be carried out earlier also.

During pregnancy you may face various other obstetrical problems like anemia hyper emesis, gravid arum, and vaginal bleeding .There may be premature labor, failure of labor to progress and higher rate of cesarean sections. The solution to all these problems lies in eating a healthy diet, getting enough sleep and exercising regularly. This will ensure that you will have a safe and healthy pregnancy. You must take care of your vitamin supplements and folic acid (a type of Vitamin B) properly. If you have a history of brain or spinal cord defects in your family or your husband’s family then it must be discussed with the doctor. Epileptic women having unplanned pregnancy should not stop their medications without advice from their doctors but must start taking 5mg of folic acid at the earliest.

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