Epilepsy and pregnancy: Managing epilepsy during pregnancy and potential effects

Managing epilepsy during pregnancy requires careful planning, monitoring and coordination between the patient, obstetrician and neurologist to ensure the health of both the mother and the unborn child. Women with epilepsy face unique challenges during pregnancy due to the potential risks associated with seizures and antiepileptic medications.
In an interview with HT Lifestyle, Dr Vinit Banga, Associate Director- Neurology and Head Neuro Intervention at BLK Max Super Speciality Hospital, shared, “One crucial aspect of managing epilepsy during pregnancy is preconception counseling. It allows women to discuss their treatment options with healthcare providers and make informed decisions about their medication regimens. Some antiepileptic drugs (AEDs) carry higher risks of birth defects, while others may be safer options during pregnancy. Switching to a safer medication before conception or during early pregnancy may help minimise risks.”
He suggested, “Close monitoring throughout pregnancy is essential to adjust medication dosages as needed. Seizure frequency may change during pregnancy due to hormonal fluctuations and other factors, so healthcare providers need to closely monitor seizure activity and adjust medications accordingly to maintain seizure control while minimizing potential harm to the fetus. Regular prenatal care is crucial for women with epilepsy to monitor the baby’s growth and development. Ultrasounds and other prenatal tests can detect any potential complications early on, allowing for timely interventions if necessary.”
Dr Vinit Banga added, “It’s also essential for pregnant women with epilepsy to maintain a healthy lifestyle, including getting enough sleep, eating a balanced diet, and avoiding alcohol and recreational drugs, which can trigger seizures and harm the developing fetus. In some cases, women with epilepsy may require specialised care during labor and delivery to minimise the risk of seizures and ensure a safe delivery for both mother and baby. Overall, managing epilepsy during pregnancy requires a collaborative effort between the woman, her healthcare providers, and specialists in maternal-fetal medicine to optimise outcomes for both the mother and the unborn child.”
Bringing his expertise to the same, Dr Bhupesh Kumar, Senior Consultant – Neurointervention and Stroke Neurologist at Artemis Hospital in Gurgaon asserted, “It’s essential to maintain stable medication levels to prevent seizures while minimising risks to the unborn child. Some anti-epileptic drugs (AEDs) pose higher risks of birth defects, so it’s crucial to weigh the benefits of seizure control against potential risks. Regular monitoring through prenatal visits can help track both the mother’s and the baby’s health. Genetic counselling may also be recommended to assess the risk of passing epilepsy to the child. Seizure frequency and medication adjustments may fluctuate during pregnancy due to hormonal changes, requiring close monitoring and adjustments as needed.”
He concluded, “Despite these precautions, there’s still a risk of adverse effects on the unborn child, including developmental delays or congenital malformations, particularly with certain AEDs. However, many women with epilepsy deliver healthy babies with proper management and monitoring throughout pregnancy. Ultimately, individualized care and close collaboration between healthcare providers are key to optimising outcomes for both mother and child.”