Epilepsy Woes During Pregnancy

By Author: Jude Mascarenhas
Total Articles: 9
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Living with epilepsy raises unique concerns when it comes to pregnancy. While most women with epilepsy deliver healthy babies and are not significantly affected during pregnancy, taking special care during your trimester is always advised. Being better informed and involving your obstetrician and neurologist in your journey will result in a better outcome for the mother and baby.

The First Thought
‘Can epilepsy be genetically passed on?’, is a question that is most commonly asked and needs to be addressed. There are several causes of epilepsy, some of which comprise:
1. Genetic inheritance
2. Genetic changes that are not inherited
3. Brain damage that may be caused during fetal development or by injury
Concurrent genetic conditions like neurofibromatosis

There is no clear answer to the question of passing epilepsy to your child. All you can do as a parent is to best understand it, curb it and work around any challenges that lead to experiencing an episode.

The chances of passing it on from mother to child are low. However, if both parents have epilepsy then the risk of ...
... the child being born with epilepsy increases. There may also be a chance of inheriting only some types of epilepsy. Or, the child may have epilepsy with no history of this condition in the family at all.

Discuss all the probable risks with your doctor. While you may be a bit apprehensive, most children, with time and correct medication, gain control over any episodes they may experience. They tend to live full and healthy lives.

What to Expect
Each body functions and reacts differently during pregnancy. Ideally, pregnant women who have epilepsy experience the same number of seizures as before or they become even less frequent. However, those who do not take the prescribed medication as directed or are sleep-deprived may experience more seizures during pregnancy.

Additionally, morning sickness may have the expectant mother throwing up the medication for seizures, resulting in increased seizures. These challenges can be addressed by maintaining a sleep schedule, taking the prescribed medication daily, and changing the medication's timing. Try taking the medication after throwing up so at last it has a better chance of working. Talk to your physician about this.

When a seizure occurs during pregnancy, the occurrence of certain challenges are possible, such as :
1. Fetal heart rate may reduce
2. Oxygen supply to the fetus may decrease
3. Low birth weight
4. Pre-term labour
5. Premature birth
6. Trauma to the mother such as a terrible fall could result in fetal injury.

However, exposure to these risks depends on the type of seizure you are affected by, which could be focal or generalized seizures. Talk to your healthcare provider for better insight into the level of risk you are exposed to. Stay connected with your loved ones and caregivers through a seizure detection watch. It is useful for sending seizure alerts to them, and it also helps keep a track of the duration and audio during your seizure. This information is important for medical purposes. Report any convulsions experienced during pregnancy to your doctor right away.

Medication and its Effects
Exposing your child to your anti-seizure medications during pregnancy can prove to be harmful. Certain birth defects are potentially associated with the side effects of ingesting AED (anti-epileptic drugs). Neural tube defects, heart and urinary tract problems, cleft palate, and skeletal problems are some of the probabilities.

Talk to your healthcare provider to adjust the AED dosage accordingly. The doctor may try to reduce peak drug concentration and switch it to more frequent yet smaller dosages. Alternatively, there are antiepileptic medicines available that are known to be safer during pregnancy.

Moreover, doctors prescribe multivitamin supplements like folic acid and vitamin K as AED ingestion makes it harder for the body to absorb these vitamins. This can result in fetal developmental issues. Folic acid helps prevent neural tube defects that are related to brain and spinal cord issues during birth. Women of reproductive age and living with epilepsy are advised to make folic acid supplements a part of their daily diet. This is because several women are unaware of their pregnancy until the neural tube closes which is close to 28 days after conception.

Certain epilepsy medications may impact a pregnant woman’s vitamin K levels as well, which play a key role in blood clotting. A vitamin K supplement injected into a newborn helps stop the bleeding. Missing out on important medication may lead to risks, that is why it is advisable to set reminders for timely medications. Using the best seizure monitoring devices can also help you with keeping a track of your daily prescriptions.

It is normal to assess the risks involved. Discuss with your gynaecologist and epilepsy treatment team about your seizure medication and any other concerns you may have. They will map out the safest medication and dosage tailored to work with your type of seizure. They will also monitor your pregnancy journey closely.