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Epilepsy and pregnancy: Healthy choices for a healthy baby
Most pregnant women who have epilepsy deliver healthy babies, yet concerns remain. Learn the importance of prenatal care, the risks of medication and more.
By Mayo Clinic staffYears ago, women who had epilepsy were often discouraged from getting pregnant. Today, the odds are in your favor. Thanks to early and regular prenatal care, more than 90 percent of pregnant women who have epilepsy deliver healthy babies, according to the Epilepsy Foundation.
If you're considering pregnancy, here's what you need to know.
Does epilepsy make it more difficult to conceive?
Occasionally seizures may disrupt the signals in your brain that tell your ovaries when to release an egg. This can affect your menstrual cycle and fertility. Medication may be an issue as well. Some drugs used to treat seizures can affect fertility.
How does epilepsy affect pregnancy?
Women who have epilepsy face a higher risk of pregnancy-related complications, including:
- Vaginal bleeding
- Premature separation of the placenta from the uterus (placental abruption)
- High blood pressure and excess protein in the urine after 20 weeks of pregnancy (preeclampsia)
- Premature birth
Does epilepsy change during pregnancy?
Every woman reacts to pregnancy differently. For most pregnant women who have epilepsy, seizures remain the same. For a few, seizures actually improve. For others, pregnancy makes seizures worse — particularly during the first trimester.
What about medication?
Any medication you take during pregnancy can affect your baby. Birth defects — including cleft palate, neural tube defects, and heart and neurological problems — are the major concern for seizure medications. But without medication, uncontrolled seizures pose more serious threats for your baby, such as oxygen deprivation. Sometimes, seizures may cause miscarriage or stillbirth.
A few women can safely taper off their medication before pregnancy. For most women, however, it's best to continue treatment during pregnancy. To minimize the risks for you and your baby, your health care provider will prescribe the safest medication that's effective for your type of seizures. No single medication is best for everyone.
As your pregnancy progresses and your blood volume increases, your kidneys may remove the seizure medication from your system more quickly than previously. Severe nausea and vomiting during early pregnancy may upset the balance as well. Frequent dosage adjustments may be needed to maintain seizure control.
What does my epilepsy mean for my baby?
Babies born to mothers who have epilepsy have a slightly higher risk of developing seizures as they get older. Developmental and growth delays are possible as well.
For babies whose mothers take seizure medication, the risk of birth defects is 4 percent to 8 percent — compared with 2 percent to 3 percent for all babies, according to the Epilepsy Foundation. The risk seems to be highest when multiple seizure medications are taken.
What should I do to prepare for pregnancy?
Before you try to conceive, schedule an appointment with the health care provider who'll be handling your pregnancy. Also meet with other members of your health care team, such as your family doctor or neurologist. They'll evaluate how well you're managing your epilepsy and consider any treatment changes you may need to make before pregnancy begins. Take your seizure medication exactly as prescribed. Don't adjust the dose or stop taking the medication on your own.
It's also important to make healthy lifestyle choices.
- Eat healthy foods.
- Take prenatal vitamins.
- Exercise regularly.
- Keep stress under control.
- Get enough sleep.
- Avoid smoking, alcohol and illicit drugs.
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