Epilepsy and pregnancy

  • Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. It is essential that sexually active females use adequate contraception to prevent an unplanned pregnancy.
  • If there is any worry that she may be pregnant, it is important that she sees her family doctor as early as possible. They should keep taking their medication until they see their doctor.

 

Planning for pregnancy – very important!!!

Prior to a planned pregnancy, a woman with epilepsy should meet with her Doctor to reassess the current need for anti-seizure medications and to determine

  1. the optimal medication to balance seizure control and avoid birth defects, and
  2. the lowest dose for going into a planned pregnancy. Any transitions to either a new medication or dosage should be phased in prior to the pregnancy, if possible.

For all women thinking of becoming pregnant, using supplemental folic acid beginning prior to conception and continuing the supplement during pregnancy is an important way to lower the risk for birth defects and developmental delays.

Prenatal multivitamins should also be used prior to the beginning of pregnancy.

Pregnant women with epilepsy should get plenty of sleep and avoid other triggers or missed medications to avoid worsening of seizures.

With the appropriate selection of safe anti-seizure medicines during pregnancy, use of supplemental folic acid, and ideally, with pre-pregnancy planning, most women with epilepsy can have a healthy pregnancy with good outcomes for themselves and their developing child.

The use of anti-seizure medications is considered safe for women who choose to breastfeed their child. On very rare occasions, the baby may become excessively drowsy or feed poorly, and these problems should be closely monitored. However, experts believe the benefits of breastfeeding outweigh the risks except in rare circumstances.

Dr C P Ravi Kumar
Consultant Paediatric Neurologist
MRCPCH, CCT (Paediatrics)
Fellow in Paediatric Neurology
Fellow in Paediatric Epilepsy

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