Seizure Disorders During Pregnancy

Most women who have a seizure disorder Seizure Disorders In seizure disorders, the brain's electrical activity is periodically disturbed, resulting in some degree of temporary brain dysfunction. Many people have unusual sensations just before a seizure... read more that is well-controlled by antiseizure medications are able to safely give birth to a healthy baby. If these women get enough sleep and take antiseizure medications 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 have

On the other hand, taking antiseizure medications increases the risk of birth defects (see table ) 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 medications.

Taking certain antiseizure medications Antiseizure drugs In seizure disorders, the brain's electrical activity is periodically disturbed, resulting in some degree of temporary brain dysfunction. Many people have unusual sensations just before a seizure... read more (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 medications with the risks of having seizures, preferably before they become pregnant. Some women may be able to safely stop taking antiseizure medications during pregnancy, but most women should continue to take the medications. The risk resulting from not taking the medications—more frequent seizures, which can harm the fetus and the woman—usually outweighs the risks resulting from taking antiseizure medications during pregnancy.

Doctors prescribe the lowest effective dose of the antiseizure medications and use as few different antiseizure medications as possible. Women who take antiseizure medications 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.