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Epilepsy and pregnancy: What you need to know

Do I need more folic acid than other pregnant women do?

Folic acid helps prevent neural tube defects, serious abnormalities of the brain and spinal cord. Because some seizure drugs affect the way the body uses folic acid, your health care provider may recommend a high-dose folic acid supplement — ideally starting three months before conception.

What can I expect during prenatal visits?

During pregnancy, you'll see your health care provider often. Your weight and blood pressure will be checked at every visit, and you may need frequent blood tests to monitor your medication levels. If you're taking seizure medications, your health care provider may recommend oral vitamin K supplements during the last month of pregnancy to help prevent bleeding problems in the baby after birth.

What if I have a seizure when I'm pregnant?

Seizures can be dangerous, but many mothers who have seizures during pregnancy deliver healthy babies. Report the seizure promptly to your health care provider. He or she may adjust your medication to help prevent other seizures. If you have a seizure in the last few months of your pregnancy, your health care provider may monitor your baby at the hospital or clinic.

How can I make sure my baby is OK?

Your health care provider will closely monitor your baby's health throughout the pregnancy. Frequent ultrasounds may be used to track your baby's growth and development. Depending on the circumstances, your health care provider may recommend other prenatal tests. What you find out may help you understand the odds and make important decisions about your pregnancy.

What about labor and delivery?

Most pregnant women who have epilepsy deliver their babies without complications.  Women who have epilepsy may use the same methods of pain relief during labor and deliver as provided to others. If you have a seizure during labor, it may be stopped with intravenous medication. If the seizure is prolonged or your labor doesn't progress normally, your health care provider may deliver the baby by C-section.

Will I be able to breast-feed my baby?

Breast-feeding is encouraged for most women who have epilepsy, even those who take seizure medication. Discuss any adjustments you'll need to make with your health care provider ahead of time. Sometimes a change in medication is recommended.

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References
  1. Pregnancy issues. Epilepsy Foundation. http://www.epilepsyfoundation.org/living/women/pregnancy/weipregnancy.cfm. Accessed April 22, 2009.
  2. O'Brien MD. Management of epilepsy in women. Postgraduate Medical Journal. 2005;81:278.
  3. Pregnancy and epilepsy. Epilepsy Foundation. http://www.epilepsyfoundation.org/answerplace/Life/adults/women/Professional/pregnancy.cfm. Accessed April 22, 2009.
  4. Schachter SC. Management of epilepsy and pregnancy. http://www.uptodate.com/home/index.html. Accessed April 23, 2009.
  5. Schachter SC. Risks associated with epilepsy and pregnancy. http://www.uptodate.com/home/index.html. Accessed April 23, 2009.
  6. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. May 6, 2009.

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Aug. 1, 2009

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