The goal for the treatment of epilepsy during pregnancy is to obtain the best possible control of seizures with minimum adverse effects for the mother and child.
Fortunately, the majority of women with epilepsy who normally have good control of seizures, experience problem-free pregnancies and deliver normal infants.
Pre-pregnancy planning is essential to reduce the risk in pregnancy. Some drugs for seizure control are contraindicated in pregnancy and others are relatively safe but may need adjustment to the dosage.
Serum levels of drugs change in pregnancy due to multiple factors. Amongst these are a change in metabolism of drugs, nausea and vomiting and lack of sleep.
It is important to consult your neurologist prior to pregnancy to ensure you are on the right medication and your seizures are controlled. Regular monitoring of serum drug levels is required during the pregnancy
pregnancy and dosage adjustments may be necessary.
A high dose folic acid supplement is highly recommended. It should be started prior to pregnancy to help reduce the risk of malformation in the baby.
The highest risk for seizures occurs during delivery. Your obstetrician will discuss the mode of delivery. For the majority of women, a vaginal delivery is relatively safe. A small number of women may be better to deliver via Caesarean section.
Breastfeeding is highly recommended as the benefits far outweigh any adverse effect of drugs being taken for epilepsy.
Postpartum, the dose of anti-epileptic drugs will need to be adjusted to pre-pregnancy levels. Occasionally a drug change is necessary. This is usually handled by your neurologist.
If you have any concerns, consult with Dr Stamatiou.