During pregnancy, epilepsy — a neurological disorder wherein the patient has a tendency to have recurrent seizures — has the potential to cause harm to both the mother and baby. According to Dr Jagriti Varshney, a gynaecologist and obstetrician, epilepsy usually happens in the “initial phases of pregnancy and can affect the foetal development.” “However, it is still considered a stigma, and hence kept hidden even from the caregivers,” she added.
Highlighting the need for awareness, Dr Nina Mansukhani took to Instagram to share that “1 in 200 women of child-bearing age suffer from this condition.” Further explaining the causes of epilepsy, the expert mentioned, “Most happen without a reason; 30 per cent have a family history, and others happen due to previous surgery or lesions.”
Effects of epilepsy on the pregnancy
Dr Mansukhani noted, “Most women have good seizure control, but poor compliance to treatment, lack of sleep, vomiting can increase the risk of seizures.” Such episodes, she stressed, may increase the risk of miscarriage or obstetric complications if seizures are associated with abdominal trauma. Similarly, “a single seizure does not cause significant oxygen deprivation in the baby, unless there are extended prolonged seizures which might cause hypoxia and foetal loss.”
Moreover, the expert mentioned that there might be growth issues in the baby, especially if there are more number of drugs being used to treat epilepsy. It can also increase the chances of performing a c-section delivery.
According to Dr Mansukhani, all anti-epilepsy medications, cross the placenta and affect the baby, and some may harm the physical development and growth of the baby, leading to common birth defects like cleft lip or palate, cardiac, skeletal, neurological development and neural tube defects. Adding to this, Dr Varshney said, “Anti-epileptic drugs have a certain amount of carcinogenic effect, so it is better to ask to your doctor for safer alternatives.”
She also advised to start folic acid 5 mg pre-pregnancy to prevent birth defects that may happen because of anti-epileptic medicines.
Things to take care of during labour:
*There is maximum risk of seizure so medications should be continued, including via IV route
*Early usage of epidural analgesia to reduce pain and anxiety
*Rectal drugs, if needed, to limit seizures
*Anticonvulsants and crash cart to be kept at hand
*Planned delivery preferred
Dr Mansukhani suggests these pregnancy care points:
*Relatives and next of kin should be taught basic first aid, emergency numbers to be at hand
*NT scan, anomaly scan and foetal 2-D echo is mandatory
*Keep ID card, name, blood group, ‘next of kin’ data always strapped to you
*Don’t change drugs without talking to your doctor
*Avoid tub bathing, driving and swimming
Busting myths related to epilepsy during pregnancy, she wrote:
*Epilepsy is not contagious
*It does not equate to psychological illness
*Having epilepsy does not mean a person is ‘possessed’
*Just one seizure does not classify as having epilepsy
*Every seizure is not due to epilepsy
Concluding, Dr Mansukhani said, “The risks of uncontrolled convulsive seizures outweigh the potential harmful effects of medication on the baby.” Adding to this, Dr Varshney said that mothers with epilepsy can pass this on to their baby, as well as increase the risk of congenital heart defects and neurodevelopmental disorders.
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