Epilepsy and Pregnancy
While pregnant women with epilepsy have a high chance of having a normal, healthy baby, there are some important precautions they should take to reduce the risk of any problems. Women with epilepsy who are thinking about becoming pregnant should talk with their doctors to discuss any special risks associated with their condition and the medications they may be taking.
An Overview of Epilepsy and Pregnancy
Women with epilepsy are often concerned about whether they can become pregnant and have a healthy child. This is usually possible. Although some seizure medications and some types of epilepsy may reduce a person's interest in sexual activity, most women with epilepsy can become pregnant.
Moreover, women with epilepsy have a 90 percent or better chance of having a normal, healthy baby, and the risk of birth defects is only about 4 to 6 percent. The risk that children of parents with epilepsy will develop epilepsy themselves is only about 5 percent, unless the parent has a clearly hereditary form of the disorder.
Women with epilepsy should be aware that some medications can interfere with the effectiveness of oral contraceptives. Women who wish to use oral contraceptives to prevent pregnancy should discuss this with their healthcare provider, who may be able to prescribe a different kind of antiepileptic medication or suggest other ways of avoiding an unplanned pregnancy.
What to Do Prior to Pregnancy If You Have Epilepsy
There are several precautions women can take before and during pregnancy to reduce the risks associated with pregnancy and delivery. Women who are thinking about becoming pregnant should talk with their healthcare provider to learn about any special risks associated with their epilepsy and the medications they may be taking.
Some seizure medications -- particularly valproate, trimethadione, and phenytoin -- are known to increase the risk of having a child with birth defects such as cleft palate, heart problems, or finger and toe defects. For this reason, a woman's healthcare provider may advise switching to other medications during pregnancy.
Whenever possible, a woman should allow her healthcare provider enough time to properly change medications, including phasing in the new medications and checking to determine when blood levels are stabilized, before she tries to become pregnant. Women should also begin prenatal vitamin supplements -- especially with folic acid, which may reduce the risk of some birth defects -- well before pregnancy.
Parents who are worried that their epilepsy may be hereditary may wish to consult a genetic counselor to determine what the risk might be. Amniocentesis and high-level ultrasound can be performed during pregnancy to ensure that the baby is developing normally, and a procedure called a maternal serum alpha-fetoprotein test can be used for prenatal diagnosis of many conditions if a problem is suspected.