Seizures occur when the brain sends out erratic signals to multiple muscle groups at the same time. Not all seizure disorders are the same, but they all begin with this erratic messaging. The most common seizure disorder affecting pregnant women is epilepsy.
The primary symptom of epilepsy is seizures, but there are symptoms directly associated with pregnancy. Pregnant women may suffer from:
- Vaginal bleeding
- Placental abruption
- Premature delivery
- Non-progressive labor
Babies born to mothers with epilepsy are at increased risk of low birth weight and some congenital side effects. Risk to the fetus may be associated with medications used to treat epilepsy or seizures.
Anticonvulsant medications are used to treat seizure disorders like epilepsy. Some seizure medications are safe for use during pregnancy when risks of stopping treatment are compared to possible pregnancy or fetal complications. Medications, like valproate, may increase the risk of birth defects. According to the Epilepsy Foundation, fetuses born to mothers with epilepsy are up to four times more likely to duffer birth defects. Common defects seen in patients with seizure disorders include neural tube defects, congenital heart problems and cleft palate. Treatment may be changed to minimize threat to the fetus while maintaining a healthy pregnancy.
Trying to Conceive
Having epilepsy could make it difficult to conceive as irregular menstrual cycles and PCOS (polycystic ovarian syndrome) may affect female patients. Medications used to treat the condition can also affect fertility or the ability to conceive.
Before trying to conceive, women should talk with their physician to ensure none of the medications they are currently taking are associated with fetal birth defects or pregnancy complications. Changes in progesterone and estrogen can cause an increase or decrease in epilepsy symptoms or seizure activity. This includes women who have been seizure free for years. Some women recognize no changes in seizure activity during pregnancy, but suffer an increase in symptoms after birth due to dramatic changes in hormone levels after delivery.
Seizures during pregnancy can be a symptom of advanced preeclampsia or eclampsia. Patients with no history of seizure disorder may require emergency medical attention if seizures occur, especially in the latter weeks of pregnancy or during labor. Seizures deprive the fetus of oxygen and may increase the risk of fetal death.
Breastfeeding with epilepsy or other seizure disorder poses no threat to the infant as long as the condition is medically under control. Having a seizure while breastfeeding does pose physical threat to the infant, but no more threat than having a seizure while bottle feeding. Some women choose to breastfeed with someone nearby during the immediate postpartum period.
Posing a more important threat to baby are anti-epileptic medications. Some medications are excreted in breast milk. Talk with your obstetrician about your desire to breastfeed prior to delivery or, if possible, prior to pregnancy.