Table of contents:
- If people with epilepsy are planning to get pregnant
- Epilepsy during pregnancy
- Treatment with drugs
- Risks of the drug sodium valproate
- The importance of folic acid
- Care during pregnancy
- Birth and later stages
Epilepsy usually starts in childhood, but it can start appearing at any age, actually. The main symptom of epilepsy is recurring seizures. Seizures occur when an abnormal pattern of electrical activity increases in the brain, which may cause the body to move out of control, and can also cause short-term loss of consciousness.
If people with epilepsy are planning to get pregnant
If you are taking anti-epileptic drugs (AEDs) and planning to become pregnant, you should continue using contraception and medications until you discuss your plans with your neurologist or GP. This is because you may need to change your medicines, and this should be done only under the supervision of a specialist.
Some AEDs can harm an unborn baby, but there is also a risk of having uncontrolled seizures in pregnancy.
Epilepsy during pregnancy
It is difficult to predict how pregnancy will affect epilepsy. Some women with epilepsy are less affected, while others think their condition is improving. However, because pregnancy is capable of causing physical and emotional stress, seizures may become more frequent and severe.
Treatment with drugs
Many women with epilepsy use AEDs to control seizures. Research has shown that there is an increased risk of Fetal Anti-Convulsant Syndrome (FACS) in children born to mothers who have taken AEDs during pregnancy. Children with FACS may have physical or brain development problems.
These drugs may increase the risk of physical disorders such as spina bifida, heart defects, and cleft lip. Depending on the type of drug and the dose, your baby may be at risk of being affected by the drug in the following cases:
- Lower intellectual abilities
- Poor language skills (speaking and understanding skills)
- Memory problems
- Autism spectrum disorders
- Delays in learning to walk and talk
Before you become pregnant, discuss your treatment with an obstetrician and neurologist who understands epilepsy. They may want to consider alternative treatments. It's usually better to change the type of medication before you become pregnant, than when or during your pregnancy.
If you become pregnant while using an AED, continue treatment and immediately contact a specialist to discuss your treatment. Do not change medications or stop taking medications without specialist advice, especially while you are pregnant, as a severe seizure during pregnancy can result in injury, or even death, to you or your baby.
Risks of the drug sodium valproate
The risk of harm to the baby is higher with some AEDs, such as sodium valproate, than with other drugs, and if two or more AEDs are taken together (called polytherapy).
The risk of physical abnormalities in infants whose mothers use sodium valproate in pregnancy is about 11%, compared with 2-3% of children in the general population. This means that out of 100 women with epilepsy who use sodium valproate during pregnancy, 11 of them will have babies with physical disorders.
The risk of neurodevelopmental problems is around 30% -40% (30-40 out of 100) in infants whose mothers took sodium valproate during pregnancy.
If you are taking sodium valproate and are planning to become pregnant, or you find out that you may become pregnant, do not stop taking the drug. See a specialist right away to discuss your pregnancy and treatment.
The importance of folic acid
If you are taking medication to control epilepsy, it is recommended that you take a high dose of 5 mg of folic acid every day, as soon as you start trying to conceive. This medicine should be prescribed to you, usually by a general practitioner, because 5 mg tablets do not apply without a prescription.
You must visit a general practitioner as soon as possible. If you become pregnant unexpectedly and haven't taken folic acid, take it right away. You can buy 400 mcg tablets in lower doses over the counter before getting a prescription for 5 mg tablets.
If you need advice, talk to your GP or pharmacist.
Care during pregnancy
Before becoming pregnant, or in early pregnancy, it is recommended that you visit a gynecologist, who will discuss and plan treatment while you are pregnant. If necessary, the neurologist may also be involved in making a joint plan.
You will be offered an ultrasound scan to help detect any developmental problems in the baby. You may need additional blood tests to check the blood levels of anti-epileptic drugs, depending on the type of AED you are taking.
You may be anxious about congenital epilepsy in babies. However, you can talk to the care team about these and other issues.
Birth and later stages
Although the risk of seizures during childbirth is low, it is recommended that you give birth in a consultant-led delivery unit at the hospital.
During the birth process, you will be looked after by a midwife or doctor who can help you if necessary. Read about what happens in birth.
Because some AEDs reduce blood clotting in babies, the baby will be injected with vitamin K immediately after birth. There's usually no reason why you can't breastfeed a baby. Although some drugs pass into breast milk, the benefits of breast milk often outweigh any risks. Your midwife, obstetrician or pharmacist can provide advice based on your circumstances.
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