Risks of epilepsy during pregnancy

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A chronic disorder or group of disorders which is characterized by recurrent, unpredictable seizures are termed as epilepsy. A seizure is a temporary physiological dysfunction of the brain,  where neurons will produce excessive electrical discharge.

Symptoms of epilepsy

  • Headache
  • Changes in mood or energy levels
  • Dizziness
  • Fainting
  • Confusion
  • Memory loss

Will My Epilepsy Change During Pregnancy?

In a study conducted by The National Institute of Neurological Disorder and Stroke (NINDS), it was estimated that about 1/3-1/2 of women with epilepsy will have more frequent seizures during pregnancy.

An increase in seizures may be due to anticonvulsant medications. The added difficulty may be due to nausea, which may cause medication to be thrown up before it can properly be absorbed into the body.

Does Epilepsy Affect My Baby?

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Depending on the type of seizure, degrees of complications also varies. As there occur partial or absence of seizures, the risk to the baby is minimal.  If a tonic-clonic form of seizure occurs, the risk of injury to the baby and mother is increased.

During a tonic-clonic seizure, there is a temporary interruption of breathing; which rarely affects the mother but may lead to oxygen deprivation in your baby.

This also increases the risk of trauma to the baby. Tonic-clonic seizures present the greatest risk during the last trimester, when the baby’s brain is larger and needs more oxygen.

Risks of Epilepsy During Pregnancy

If seizures occur during pregnancy, a number of complications can occur affecting the baby including:

  • Fetal heart rate deceleration
  • Fetal injury
  • Miscarriage due to trauma
  • Premature separation of the placenta from uterus
  • Preterm labor
  • Premature birth

Anti-convulsant Medications during Pregnancy

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A primary concern for expecting mothers with epilepsy is the effect the medication that can have on the baby. Epileptic women have a 4-6 % chance of having a baby born with a birth defect as a result of taking anticonvulsant drugs.  Some mild defects including small fingers and toenails, birth defects such as spina bifida, neural tube defects, cleft lip and heart abnormalities may occur. Do consult a doctor and they may recommend changing the medication or lowering the dosage of the current medication.

Under any circumstances, don’t ever try to stop medication without consulting a doctor.

Precautionary Measures

There are steps that should be taken care of when one is epileptic and want to ensure the healthiest pregnancy possible. Preconception counseling should be done with a doctor before you get pregnant. Doctor will review the medical history in order to determine whether a change in the anticonvulsant medication is needed. Be careful while taking folic acid before and during pregnancy because anticonvulsant medications can interfere with the folic acid levels in the body, and low levels of folic acid can lead to neural tube defects. Studies reveal that taking folic acid during the first three months of pregnancy decreases the risk of spinal bifida. However, it is advised to consult your doctor before taking folic acid, as it may cause interactions with some anticonvulsant medications, making them less effective and increasing your chances of having a seizure.

What to Do After Birth

Labor and birth may affect the health and well-being of the mother.  Studies have shown that in two days following the birth of the baby, women with epilepsy are more likely to have a seizure.

Contributing factors

  • Sleep deprivation
  • Hyperventilation
  • Stress
  • Physical pain
  • Failure/inability of the women to take medications

Mother must take plenty of rest, remain stress free, and take her medications as prescribed by her doctor. Getting help from family and friends or using a postpartum doula may help to reduce stress.

Can I Breastfeed if I am Epileptic?

Women with epilepsy are also encouraged to breastfeed, because of the numerous benefits of breast milk for the baby. Talk with your doctor to know about the benefits of breastfeeding against the mother’s use of anticonvulsant medication.