Seizure Disorders During Pregnancy
Most women who have a seizure disorder that is well-controlled by antiseizure drugs are able to safely give birth to a healthy baby. If these women get enough sleep and take antiseizure drugs in appropriate doses, the number of seizures usually does not increase during pregnancy, and pregnancy outcomes are usually good. However, these women are slightly more likely to
On the other hand, taking antiseizure drugs increases the risk of birth defects (see table Some Drugs That Can Cause Problems During Pregnancy) and may slightly reduce intelligence in the baby. However, these risks may be increased by the seizure disorder as well as by the use of antiseizure drugs.
Taking certain antiseizure drugs (such as phenytoin, carbamazepine, or phenobarbital) during pregnancy increases the risk of hemorrhagic disease of the newborn (which causes a tendency to bleed easily). However, if women take prenatal vitamins with vitamin D and if vitamin K is given to the newborn, hemorrhagic disease rarely occurs.
Thus, women who have a seizure disorder should talk to an expert in the field about how to balance the risks of taking antiseizure drugs with the risks of having seizures, preferably before they become pregnant. Some women may be able to safely stop taking antiseizure drugs during pregnancy, but most women should continue to take the drugs. The risk resulting from not taking the drugs—more frequent seizures, which can harm the fetus and the woman—usually outweighs the risks resulting from taking antiseizure drugs during pregnancy.
Doctors prescribe the lowest effective dose of the antiseizure drugs and use as few different antiseizure drugs as possible. Women who take antiseizure drugs need to take a high dose of a folic acid supplement daily. Ideally, it is started before they become pregnant. Taking folic acid supplements helps reduce the risk of having a baby with a birth defect.
Vaginal delivery is usually possible. Cesarean delivery is done only if women have repeated seizures during labor or other problems develop and require it.