During Pregnancy – Checklist

August 5, 2011

Safe and successful vaginal delivery is accomplished in the majority of cases of women with epilepsy. Caesarean sections are not imperative just because you have epilepsy.

  • At regular intervals throughout your pregnancy, your health care provider should evaluate the number and frequency of seizures, as well as your blood levels of antiepileptic medication(s).
  • Regular obstetrical follow-up from early pregnancy to term is recommended, including prenatal diagnosis by ultrasound and the alpha-fetoprotein test to detect malformations, as well as continuous monitoring to assess fetal well-being throughout your pregnancy.
  • Take a daily folic acid supplement thoughout your pregnancy.
    Take a daily vitamin K supplement during the last trimester.
  • Control of nausea and management of vomiting during pregnancy is important, because vomiting may interfere with your antiepileptic drug intake, absorption and compliance.Alternative options for nausea and vomiting control are preferred to minimize drug interactions:
    • acupuncture
    • hypnosis for relaxation
    • ginger products
    • dill pickles
    • lemon juice mouth rinses.

Other drugs may be taken, but consult your doctor first.

  • Any drug schedule compliance problems should be brought to the attention of your health care provider immediately.
  • Try to minimize certain lifestyle factors that will increase risks for seizures during pregnancy:
    • poor sleep
    • poor compliance with medication schedule
    • increased life stressors
    • high levels of estrogen, etc.

FACT: Status epilepticus (dangerous nonstop seizures which persist for more than 5 minutes) will put the fetus, as well as the mother, at risk for death.

Status epilepticus may have metabolic causes, or may occur due to the discontinuation or irregular use of antiepileptic drugs, intoxication, infection and even highly stressful and volatile situations, such as abuse or assault.

  • During labour, it is important to continue with your antiepileptic medication. (You may want to switch to intravenous or intramuscular administration at low levels.)

Recurrence of seizures during delivery is not dependent on one kind of antiepileptic drug during pregnancy.

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