According to Dr. Atul Prasad - Head of Neurology, BLK MAX Super Specialty Hospital (India), epilepsy is a chronic brain disorder that causes seizures due to abnormal electrical activity in the brain.
Women with epilepsy can have healthy pregnancies but face increased risks, including seizures and complications such as preeclampsia or fetal growth restriction.
Dr Atul Prasad outlines what mothers need to know about the effects of epilepsy on pregnancy and how to cope:
Plan before conception
Women with epilepsy should consult with their neurologist and obstetrician before conceiving. This will allow for reassessment of the condition, adjustment of antiepileptic medication (ASM) and consideration of switching to less risky medications.
Managing seizures in pregnancy
About 50% of women with epilepsy during pregnancy do not have a change in seizure frequency, but 30% may experience an increase in seizure severity. Generalized tonic-clonic seizures (GTCS) can cause oxygen deprivation, injury, miscarriage, and even sudden death if not well controlled.
Pregnancy complications
Epilepsy can increase the risk of miscarriage, premature birth, fetal growth restriction, and preeclampsia. However, epilepsy does not increase the risk of cesarean section unless there are uncontrolled seizures, in which case a cesarean section may be necessary.
Prenatal monitoring
Women with epilepsy should undergo prenatal screening tests such as detailed ultrasound and fetal echocardiography to detect structural abnormalities.
Monitoring for obstetric complications such as preeclampsia is important. In particular, if the mother is taking medications such as phenobarbital, the risk of premature birth or low birth weight may be higher.
Labor, delivery and postpartum
Most women with epilepsy can have a normal delivery, but stress and sleep deprivation during labor can trigger seizures. After delivery, anti-seizure medication doses may need to be adjusted because of pregnancy-related metabolic changes. New mothers should prioritize sleep and seek support to reduce the risk of seizures.
Emotional and psychological support
Being pregnant with epilepsy can increase feelings of anxiety. Joining a support group and getting counseling can help women feel confident in dealing with the challenges of pregnancy and caring for their baby after birth.
