Seizure Disorder (Epilepsy) & pregnancy

Seizure Disorder (Epilepsy) & pregnancy

About 1% of Americans suffer from seizure disorder commonly known as epilepsy. A seizure is a temporary physiological dysfunction characterized by a jerking motion and convulsions. This is caused by an abnormal or excessive electric discharge produced by neurons in the brain.  The idea of having seizures while pregnant is frightening for any mother as a number of things can go wrong and cause harm to both mother and child. Some women decide to stop taking their medication due to the fear of birth defects associated with seizure medications. This usually causes more harm and in some cases can be fatal. Do not stop taking your medication, rather speak to your doctor about the other safer options available. For a second medical opinion, visit us at 67th Street OB/GYN Total Women’s Health Care and speak to one of our OB/GYNs in Manhattan today.

Due to the physiological changes in a woman’s body during pregnancy, the effectiveness of the antiepileptic Drugs (AED) may be altered. About 25-40 percent of women experience more frequent seizures, others either experience less or the same amount of seizures they did before pregnancy1. This wide range is also due to the number of women who stop taking your AEDs during pregnancy. It is important to note that at lower levels, the risks of birth defects are low and only increases as the dosage goes up. Hence it is important to discuss your medication options with your doctor and to keep every prenatal visit recommended by your doctor as the level of the AEDs in your blood will be closely monitored.

What are the risks to the mother?

For some women, their pregnancy is unaffected by their seizure disorder. The cases where the mother does not experience any seizures in the 9 months preceding conception are often shown to have a healthy successful pregnancy. While in others, especially in those with the more serious cases, their pregnancy can be severely affected, especially if they do not take their AEDs regularly or if they stop taking them. Below are some complications a mother may experience:

  • Pregnancy Hypertension
  • Injuries from falls and biting self
  • Aspiration of fluids in the lungs of the mother
  • Pneumonia as a result of lungs filling with fluids
  • Death in rare and severe cases
  • Brain damage in mother (strokes or other permanent damage)
  • Hearing problem: the mother may develop hearing problems
  • Excessive bleeding due to medication: Some AEDs have been shown to affect vitamin k which is essential in the blood clotting process1.

What are the risks to the baby?

The type of seizure experienced coupled with the dosage of medication taken during pregnancy determines the type/ severity of complication. Below are some risks to the baby due to the seizure disorder or medication taken to stop/control these seizures:

  • Miscarriage due to trauma from tonic-clonic form of seizure
  • Fetal injury: This is due to the violent jerking motions and falls that are associated with seizures. The more frequent the attacks, the higher the chances of fetal injury.
  • Preterm labor: excessive seizures during the third trimester may result in early labor.
  • Fetal Heart deceleration
  • Premature separation of the placenta from the uterus
  • Stillbirth
  • Smaller babies
  • Birth defects caused by the AEDs the mother takes: the risk of birth defects increases with dosage. Hence the importance and constant monitoring of AEDs in the mother’s blood.

Though there are risks associated with AEDs, the benefits to both the mother and child outweigh these risks as more seizures during pregnancy can be fatal to mother and child. For more information on your situation, and how your AEDs affects your baby, consult with one of our obstetricians in Manhattan today.

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