Epilepsy during Pregnancy

Epilepsy is a condition in which a person has repeated seizures over time. Epilepsy can cause problems during pregnancy, but with the right care the chances of having a normal, healthy baby are good. Most women with epilepsy have normal pregnancies and healthy babies.

What kind of problems can epilepsy cause during pregnancy?

The problems that may happen due to epilepsy depend on whether or not you take medicines for your condition during your pregnancy. Without treatment, epilepsy can put you and your baby at risk for certain problems, including:

• More frequent seizures than usual.
• Placenta problems.
• Premature labor and birth.
• Slowed heart rate and low oxygen supply to the baby.
• Slower than normal growth in the uterus (intrauterine growth restriction).

How is epilepsy treated during pregnancy?

During pregnancy, treatment for epilepsy may include:

• Taking a medicine that helps prevent seizures (antiepileptic drug). This medicine is commonly prescribed for women who have had seizures within several years of the pregnancy.
• Taking a higher than normal doses of folic acid. Folic acid helps prevent your baby from developing spinal cord defects.

Working with your health care provider and going to all your prenatal appointments is an important part of treatment.

Will my medicine affect my baby?

Antiepileptic medicines can affect you and your baby by increasing the risk for:

• Vaginal bleeding early in pregnancy.
• High blood pressure during pregnancy (preeclampsia).
• Birth defects.
• Labor induction. This is when you fail to go into labor, and labor has to be started for you.
• A cesarean delivery.
• Complications after birth.

Most of the time, medicines are prescribed anyway because the risk of the medicines harming your baby is lower than the risk of a seizure harming your baby. If your health care provider prescribes this medicine, he or she will prescribe the safest kind of medicine at the lowest dose that will still prevent seizures. You will also have blood tests often to make sure that the medicine is at a safe level.

What if I have a seizure while I am pregnant?

Women with epilepsy are more likely to have seizures during pregnancy due to hormonal changes, stress, or a lower dose of seizure medicine. It is important to carefully follow your medicine and seizure-control plans during pregnancy. If you have a seizure during your pregnancy, your risk for early delivery may increase.

Will I be able to breastfeed my baby?

Women with epilepsy are encouraged to breastfeed. The antiepileptic drug may pass through your breast milk in small amounts, but the amount is usually not enough to affect your baby.

Contact a health care provider if:

• You think you are having seizures.
• You do not feel the baby moving as much as usual.
• You develop tiredness or weakness.
• You feel like you are going to faint.

Get help right away if:

• You have very bad abdominal pain.
• You have vaginal bleeding.
• You do not feel the baby moving.
• You have very bad headaches.
• You have vision problems.
• A part of your body feels numb.
• You cannot stop vomiting.

Summary

• Epilepsy is a condition in which a person has repeated seizures over time.
• Most women with epilepsy have normal pregnancies and healthy babies.
• Follow your healthcare provider’s recommendations regarding management and treatment of epilepsy during pregnancy.