Focus On with Dr. Sadek: Women’s Health and Epilepsy
Pregnancy poses a unique set of challenges to women with epilepsy.
Pregnancy poses a unique set of challenges to women with epilepsy. Although women with epilepsy have certain risks that need to be assessed and monitored, most women with epilepsy go on to have healthy babies.
Planning is key when it comes to managing epilepsy during pregnancy. Anti-seizure medications can pose a risk of fetal malformation. However, in most cases these risks are quite small (4 to 6 percent on average). Some medications have higher risks than others, and taking multiple anti-seizure medications or medications at high dosages can result in greater risks.
Women of any child-bearing potential should be advised on taking a folic acid and prenatal supplement to decrease risks of birth defects. Meeting with an epilepsy specialist before conception is ideal to establish an ideal medication regimen for conception. Some women may see a high-risk obstetrician during pregnancy for extra monitoring of the baby.
Some women may want to be off anti-seizure medication for the pregnancy. However, this may not be safe, and it could result in an increased risk of seizure and injury during pregnancy. Most women continue to have the same level of seizure control throughout the pregnancy as they did before pregnancy. However, sometimes medication levels will drop during pregnancy because of changes in hormone levels. This is why it is very important to see your epilepsy specialist often during your pregnancy and get your medication levels checked regularly.
Breastfeeding is still recommended for most women with epilepsy, even those who take anti-seizure medication. Although the baby may receive some medication through breastmilk, this is typically a much smaller amount the baby received inside the womb. In general, it is felt that the great benefits of breast milk outweigh any potential risks. However, you will need to discuss this with your epilepsy and obstetrical team.
Women with epilepsy can increase their chances for a healthy pregnancy by meeting early and often with their obstetrical and epilepsy team. Consider reaching out to an epilepsy specialist near you to discuss your child-bearing plans.
Dr. Ahmed Sadek | Orlando Epilepsy Center, Inc.
Dr. Sadek is the Director of Orlando Epilepsy Center. He is an Assistant Professor of Neurology at the University of Central Florida College of Medicine and a Clinical Assistant Professor of Neurology at the University of Florida Shands, Gainesville. Dr. Sadek is triple Board certified in Neurology, Clinical Neurophysiology, and Epilepsy.