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Pregnancy relatively safe for epileptic women: US Academy of Neurology

Stopping antiepileptic drugs is not the best option for epileptic pregnant women

As with any other disease, epilepsy can occur in pregnant women, causing concerns among many of them over the possible effect of the illness on the infant. These concerns include questions over the possibility of delivering disabled infants, experiencing difficulty in delivery, or passing the illness on genetically.

However, scientists, professors, and general guidelines confirm that most epileptic women deliver healthy infants. According to the guidelines of the US Academy of Neurology, taking antiepileptic drugs (AEDs) during pregnancy does not increase the risk of a difficult pregnancy. The guidelines stated that there is no scientific evidence that links taking AEDs during pregnancy with an increased risk of late-pregnancy bleeding.

The guidelines said there is very little scientific evidence that AEDs increase the risk of needing a caesarean section. There is however positive evidence that epilepsy may lead to a very high risk of early contractions or early labour and delivery. There is little evidence that taking AEDs during pregnancy increases the risk of having pregnancy-related high blood pressure.

The guidelines further clarify that infants delivered by epileptic women are at no higher risk of dying in the first month after birth than those delivered by non-epileptic women.

According the guidelines, it is highly recommend that all epileptic women who are planning for pregnancy take folic acid (vitamin B9) regularly to reduce the risk of any defects in the embryos.

The guidelines also recommend that pregnant epileptic women avoid smoking at all, since evidence indicates that women who smoke during pregnancy may increase the risks of early contractions, labour, and delivery, even if they are not taking AEDs during pregnancy.

According to Medscape medical website, pre-conception management of women with epilepsy includes the following:

  • Reduction of pharmacotherapy (therapy using pharmaceutical drugs) and using monotherapy (using a single drug to treat a disease) instead
  • Epileptic women who have not had a seizure for two to five years should try to complete withdrawal of pharmacotherapy
  • Lowering dosages of AEDs to the lowest possible dose
  • Maintaining the amount of total and free AEDs, which are important for reaching good clinical control
  • Considering pre-conception genetic counselling

According to the website, the management of epilepsy during pregnancy includes:

  • Monitoring the level of total and free AEDs per month
  • Paying attention to the importance of early genetic counselling
  • Considering amniocentesis for alpha-fetoprotein and acetyl cholinesterase

The guidelines stated it is important for epileptic women to consult their doctors when deciding to remain on AEDs during pregnancy. Women should be informed that some AEDs are safer than others. Stopping AEDs before or during pregnancy is not the best option for women with epilepsy.

For pregnant women who take one brand of AED, switching to another brand may cause other health problems. The guidelines recommend that consulting a doctor is the best way to avoid any harm or complications. The guidelines further assure that pregnancy in epileptic women is relatively safe for both the mother and child.

Topics: pregnancy

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