The chances of having a normal, healthy child are excellent and are greater than 90 per cent. Both the neurologist and the obstetrician need to be involved in reviewing the anti-epileptic drug that the woman is taking and in deciding whether there is need for a change in medication prior to conception. It is best to be on a single drug rather than a combination of drugs.
Though there is a slightly increased risk of certain abnormalities in the baby due to epileptic drugs, these problems can be prevented by taking folic acid supplementation (about 5mg per day) particularly prior to conception and in the first three months of pregnancy. A good quality detailed ultrasound in the 5th month can ensure that the fetus does not have any birth defect. There may be a need to increase the dose of the anti-epileptic drug in pregnancy.
If you have epilepsy, it is smart to take certain precautions before you get pregnant to ensure that you stay healthy and have a healthy baby. See your doctor before getting pregnant to discuss your medication. If there has been no seizure in two or more years, it may be possible to stop the medications gradually. If the medications cannot be stopped, then your doctor will recommend medicines that are safe during pregnancy. However, seizures are more harmful than any medications taken, so never stop taking medicines if you are pregnant. Antiepileptic drugs influence the way the body uses folic acid. So make sure you take a folic acid supplement along with your medication.
Epilepsy risks for the baby
In all women the risk of having a baby with a birth defect is 2 to 3 per cent. Women with epilepsy have a slightly higher risk, about 6 to 8 percent, of having a baby with a birth defect. This risk may be associated with the disorder or to the medicine used to treat it. Though rare the problems that are seen in epileptic mothers include:
- Cleft lip or palate in the baby
- Heart defects
- Neural tube defects in the baby
- Small head
- Baby having a low birth weight
- Intrauterine growth restriction (IUGR)
- Mental retardation in the baby
- Bleeding problems at birth
Children of women with a seizure disorder may also run the risk of developing epilepsy later on in life.
Epilepsy delivery
There is no reason why a woman with epilepsy cannot have a vaginal delivery. Like any other woman, she may require a caesarean section only if there is a problem during pregnancy and labor.
Postpartum care in women with epilepsy
After delivery, the medication to control the seizures may need to be adjusted. Just after birth, your baby will be given an injection of vitamin K to prevent any bleeding problems. This is because antiepileptic drugs lower the natural levels of vitamin K in the body.
Breastfeeding in women with epilepsy
Women on a single drug can safely breastfeed their babies in consultation with their pediatrician. Antiepileptic drugs can be found in small amounts in breast milk, but will seldom affect the baby.
