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  • Writer's pictureDr Parul Chopra Buttan

Epilepsy in Pregnancy

This information is for you if you have epilepsy and want to know more about epilepsy in pregnancy. It may also be helpful if you are a partner, relative, or friend of someone who has epilepsy and is pregnant or planning a pregnancy.

What does having epilepsy mean for me and my baby?

Some women with epilepsy may have more seizures when they are pregnant. This is usually because they have stopped taking their medication, or are not taking it regularly.

Pregnancy itself or tiredness can also increase the number of seizures. If this happens to you, you should consult your healthcare professional.

A very rare but serious complication of poorly controlled epilepsy is sudden unexplained death with epilepsy (SUDEP), which may occur more frequently in pregnancy.

What does having epilepsy mean for me and my baby?

With any pregnancy, there is a small chance that your baby may not develop normally in the womb.

The risk depends on the type of medication you are taking and the dosage, and it increases if you are taking more than one medication for epilepsy.

The most common problems for your baby linked to these medications include spina bifida, facial cleft, or heart abnormalities. Taking folic acid reduces this risk.

I have epilepsy. What should I think about before becoming pregnant?

Talk to your gynecologist and physician/neurologist- Most women with epilepsy have healthy babies. It is important that you let your gynecologist know that you are planning to have a baby. You may be referred to a neurologist or epilepsy specialist for advice who will be able to talk to you about what pregnancy will mean in your individual situation.

Start taking folic acid at the higher dose of 5 mg daily- All pregnant women are advised to take folic acid as it helps to reduce the risk of their baby having spina bifida. It may also reduce the risk of heart or limb defects. Your doctor will advise you to take a daily dose of 5 mg of folic acid.

I was not planning a baby but I have found out I am pregnant

Do not stop your medication- Most epilepsy medication itself only carries a small risk to your baby, whereas stopping your medication could pose a serious risk to both you and your baby.

Talk to your gynecologist and physician/neurologist- They will arrange for you to see an obstetrician or neurologist who will be able to give you advice.

Taking folic acid- If you are not taking folic acid already, you should start taking it now. You should take the higher dose of 5 mg daily.

If nausea or vomiting makes it difficult to keep your epilepsy medication down, talk to your gynecologist and physician, midwife, or epilepsy specialist.

What extra care will I need during pregnancy?

You should consult an obstetrician with expertise in high-risk pregnancy, ideally while planning your pregnancy and then as soon as you are pregnant.

At your first visit you will be given information about:

  • Ways to reduce the risk of having seizures, for example by making sure that you take your medication and by trying to get as much sleep/rest as possible

  • Having epilepsy will usually mean more clinic visits at the hospital. Your team will discuss your general health with you, and whether you have had any seizures recently. You may be advised to increase or alter your medication if the number of seizures you are having has increased.

  • Like all pregnant women, you will be offered routine ultrasound scans to check how your baby is developing. This includes checking your baby’s spine and heart. You may be offered additional scans to monitor the growth of your baby if you are taking medication for epilepsy.

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