Planning for Pregnancy with Epilepsy

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Planning for pregnancy can be an exciting time for women and their families. Whilst there is an increased risk of complications during pregnancy, most women with epilepsy have healthy babies.

Planning is essential, so it is important for you to seek the advice of your neurologist before planning to have a baby.  A safe pregnancy is more likely to occur when you have consulted with a neurologist prior to becoming pregnant, and have developed a plan to manage the risks associated with pregnancy and epilepsy.

Planning for pregnancy can be an exciting time for women and their families however many women are concerned epilepsy may have an impact on their ability to have a safe pregnancy.  Most women with epilepsy (93%) will have a successful pregnancy and give birth to a healthy baby. Risks to consider If you have epilepsy the risks associated with pregnancy do not mean you cannot have a baby. However, it is important to be aware of these risks so that you can discuss management strategies with your neurologist or obstetrician prior to conception. Some of the main risks include:

  • 25-30% of women experience an increased number of seizures during pregnancy, especially in the third trimester
  • Tonic-clonic seizures may cause harm and injury to the pregnant woman and foetus if not managed adequately
  • Some anti-epileptic drugs (AEDs) can increase the risk of congenital malformation and birth defects however this increased risk is small, occurring in 4-6% of women taking AEDs compared to 2-3% in the general population
  • Foetal death and stillbirth are more likely to occur, affecting 1.3-14% of pregnant women with epilepsy compared with 1.2-8% in the general population

Managing these risks

Visiting your doctor prior to conception The first thing you should do if you are planning for pregnancy is to arrange a consultation with your neurologist. In this appointment your doctor may want to consider the following questions:

  • Do you have the correct epilepsy diagnosis?
  • Are your seizures managed effectively?
  • Are you on the lowest possible dose of medication for managing your seizures?
  • Does your medication need to change before conception

Your doctor may be concerned about these issues because it is very important to have the best possible seizure control and be on the safest AED prior to becoming pregnant. Abnormalities caused by AED’s may occur during the first three months of pregnancy whilst increased seizures, especially tonic-clonic seizures, are more likely to harm your developing baby during the last three months of pregnancy.

Risk management prior to conception

When planning pregnancy, it is very important not to stop taking your AEDs without the guidance of a medical professional. Your doctor may encourage you to change the dose or type of AED prior to you attempting to conceive, as some medications are safer for the foetus than others.  Your doctor may also encourage you to start taking folic acid well before you try to conceive. This can reduce the risk of congenital abnormalities that are more likely to affect the babies of women with epilepsy.

Risk management throughout pregnancy

Your doctor may encourage you to manage the risks associated with your pregnancy by doing the following:

  • Attending regular visits throughout your pregnancy with your neurologist and obstetrician
  • Continuing to take folic acid as prescribed by your doctor
  • Reporting any changes to your seizure control to your doctor
  • Monitoring the level of AEDs in your blood to determine whether they are at an adequate dosage and modifying the drug dose (older AEDs more commonly than the newer AEDs) where appropriate

Outlook

Women with epilepsy have a high chance of having a successful pregnancy and a healthy baby. However, it is important to remain educated about the possible risks associated with  pregnancy and epilepsy. Planning for pregnancy in consultation with your neurologist well in advance of conception is the best way to increase your chances of having a healthy pregnancy and baby.

Other resources

The Australian Pregnancy Register can provide further information about epilepsy and pregnancy, and the use of AEDs during pregnancy. Contact them on 1800 069 772 or visit their website at: http://www.neuroscience.org.au/australian-epilepsypregnancy-register

Other helpful information including about pregnancy and epilepsy can be found at on our website.

For more information contact our Information Line on 1300 761 487.

 

 

© Epilepsy Foundation July 2017. The information contained on this page provides general information about epilepsy. It does not provide specific advice.
Specific health and medical advice should always be obtained from a qualified health professional.