Seizure Disorders and Pregnancy: What you Need to Know

A seizure is when brain activity becomes abnormal and can cause abnormal movements, awareness, or emotional states. Epilepsy, which is only one type of seizure disorder, tends to be the most well-known. This occurs when there is no known cause for the seizures.

Pregnancy can have a major effect on seizure disorders, and having a seizure disorder can affect a developing baby and make a pregnancy high risk. Therefore, if a woman has a seizure disorder and wants to become pregnant or already is, she should get in touch with her doctor immediately to make a plan to have the healthiest pregnancy possible.

About 30 percent of women with seizures will notice the frequency increases during pregnancy. The remainder will usually have the same amount or less frequent seizures. If a woman is on anti-seizure medication, she should not suddenly stop taking it because her seizures have decreased, since this can cause them to increase again.

Multiple anti-seizure medications exist, with some that are safe to take in pregnancy. Ideally, a woman who is on anti-seizure medication will have a preconception visit so she can make sure the medicine is OK for pregnancy. If not, she can then be switched to one that is.

Women with seizures are at a higher risk of having a baby born with birth defects compared to women who don’t have seizures. This is thought to be caused by the disorder itself, but may also be a side effect of some anti-seizure drugs. Because of this, women with seizures should take extra folic acid while trying to conceive (another reason a preconception visit is important!) and in the first trimester to decrease the chance of one group of birth defects called neural tube defects.

Seizures during pregnancy can be dangerous both for a mother and her developing baby. Seizures, such as grand mal seizures (where a person loses consciousness and has large jerking motions), can cause falls, head injuries, and abdominal trauma, which may lead to bleeding, placental abruption, and preterm birth. If this happens, a woman should contact her doctor immediately to see if she needs to seek emergent care or be monitored in Labor and Delivery.

A woman with seizures should be able to have a vaginal delivery and go on to breastfeed, since many anti-seizure medications are safe to use while nursing. It will be important to review birth control options as certain seizure medications can affect how well some birth control works, and there are even some types of birth control that are thought to help decrease seizure frequency.

Sources:

• The American Congress of Obstetricians and Gynecologists
• FAQ 129: Seizure disorders in pregnancy
• February 2013.
  RK Creasy and R Resnik
• Chapter 55: Neurologic disorders
• Maternal-fetal medicine: principles and practice
• 5th

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