National Epilepsy Day 2022: How Safe Is Pregnancy For Women With Epilepsy

Epilepsy is a neurological disorder and pregnant women might experience seizures. Let’s know what doctor has to say.

Chanchal Sengar
Written by: Chanchal SengarUpdated at: Nov 17, 2022 14:31 IST
National Epilepsy Day 2022: How Safe Is Pregnancy For Women With Epilepsy

Pregnancy is a special period for any woman. But for women suffering from epilepsy, it could be a challenging task. This National Epilepsy Day, Dr. Rohit Pai, Consultant Neurologist, KMC Hospital, Mangalore, explains the link between pregnancy and epilepsy.

What is Epilepsy?

Epilepsy is a medical condition in which the electric signals sent by the brain become scrambled, which may lead to a sudden burst of electrical activity. Epilepsy causes seizures in the human body. In the majority of cases, it’s hard to find the exact reason that causes epilepsy.

Epilepsy in Pregnant Women

Epilepsy in women carries a social stigma. In India, epilepsy affects around 55 lakh people out of which 25 lakh are women and among them 13 lakh women come under the reproductive age group. So, pregnant women may experience mild changes because of epilepsy. In pregnancy, there is a 20 to 30% increased risk of getting a seizure as compared to non-pregnant individuals.

Also Read: All About Epilepsy In Children

Anti-epileptic Drugs During Pregnancy

Certain drugs are deleterious in pregnancy, as they can cause major congenital malformations. Drugs like Phenobarbitone, Phenytoin, Sodium Valproate, which are used as anti-epileptics can cause congenital malformation in the foetus. Such anti-epileptic drugs are needed to be avoided.

Epilepsy in pregnancy

Anti-epileptics like Levetiracetam, Lamotrigine, and Oxcarbazepine are preferred in pregnancy. There are certain changes that happen in women’s metabolism because of these drugs during pregnancy. In the second and third trimester of pregnancy, there is an increase in haem dilution, that is, increase in water content in the blood.

  • If the absolute concentration of these antiepileptics reduces, then there is a tendency for increased seizure during pregnancy. The reasons for these changes are sleep depression and anxiety during pregnancy in the second trimester and third trimester.
  • There is increased haem dilution causing reduced levels of drugs.
  • There is an increase in elimination of these on the body of women who have remained seizure free one year prior to pregnancy.
  • The chances of them getting a seizure during pregnancy is less.

So it is advisable to plan your pregnancy if there is a seizure free interval of at least for one year.

Also Read: Know What To Do and What Not To Do During A Seizure

Important Suggestions

It is suggested one must  consume folic acid supplementation if you are planning a pregnancy. This will prevent neural tube defects, which can happen due to certain anti-epileptics, which is formed within the first 24 to 28 days of gestation. So, by the time you know that you're pregnant, the neural tube is already almost formed. So it is advisable to start taking folic acid supplementation when you're planning pregnancy.

It is also advisable to avoid sleep deprivation during pregnancy. Any episodes of hyperemesis where either excessive vomiting needs to be treated immediately because when you get excessive vomiting, your chances of medicine getting absorbed into the body is less.

If women are on polypharmacy under consultation of neurologists and if seizures are under control, it is advisable to reduce the number of drugs. It's also advisable to lower the dosage of drugs of the anti-epileptic the patient is taking. So, a lowered dose of drugs can lessen the chances of side effects, but this has to be done under the neurologist’s advice.

Men with epilepsy also have a higher chance of infertility compared to non-epileptics. It is advisable to change the medicines like sodium valproate, which can cause congenital malformation or can cause infertility. Safer drugs like Lamotrigine oxcarbazepine drugs, which are prescribed often, should be taken on time as we advise for any epileptic patients, so drug compliance, avoiding sleep deprivation, using the correct dose of medicines and taking it at the correct time is important.

Smoking and alcohol should be avoided. There are certain drugs that are enzyme inducers. It is also advisable to give vitamin K to the new-born after delivery to prevent bleeding tendency.

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