Epilepsy attacks during pregnancy24.05.2022
Epilepsy and pregnancy are rare at the same time. There are no strict contraindications to bearing and giving birth to a mother with this disease. Management of pregnancy and childbirth is carried out taking into account the activity of epilepsy, it is better to become pregnant in remission. Women need to prepare in advance for the onset of pregnancy, it is necessary to switch to the safest drug in advance. If against its background the course of epilepsy does not worsen, you can become pregnant.
What is this disease
Epilepsy is a chronic disease in which “extra” foci of electrical activity are formed in the brain. They function inconsistently with the main nerve nodes. When such a focus is turned on, a convulsive attack occurs.
Depending on the size and location of the focus, an epileptic seizure manifests itself in different ways. Sometimes there are no convulsions, and the person simply falls into a state of stupor. After that, he does not remember what happened to him.
Epilepsy and pregnancy are compatible concepts, but strict medical supervision is needed
Causes of epilepsy
Depending on the cause of development, three types of the disease are distinguished:
- cryptogenic – it is impossible to establish the cause;
- idiopathic – hereditary predisposition, genetic disorders;
- symptomatic – the presence in the brain of tumors, cysts, hemorrhages, consequences of injuries.
More than 50 million people in the world suffer from epileptic seizures.
Symptoms of the disease
An epileptic seizure occurs suddenly. It is provoked by flashes of light, loud sounds, stress, fever. There are several types of seizures.
- Absence is the easiest option. This is a sudden blackout of consciousness for 3-4 seconds. A person ceases to move and perceive the world around him. At the end of the attack, he continues his activities.
- Partial seizure – one part of the body is involved. It can manifest itself in the form of muscle twitches, sensations of heat or cold, crawling.
- Generalized convulsions take over the whole body. The man falls, clenching his jaw. Muscle twitching extends to limbs and trunk.
The frequency of seizures determines the severity of epilepsy. Patients have a change in character, a decrease in mental activity.
Possibility of pregnancy
The possibility of a combination of epilepsy and pregnancy depends on the severity of the disease and the nature of the seizures. It is not recommended for a woman to become pregnant with frequent generalized convulsions, pronounced personality changes. If epilepsy is manifested by rare absences or partial seizures, there will be no harm to the child.
Epilepsy is an unpredictable disease. It is impossible to predict in advance whether it is dangerous for the mother and fetus. In some patients, pregnancy improves the course of the disease: the number of seizures decreases, the severity weakens. In others, during pregnancy, a mild form of the disease becomes severe.
Seizures may become more frequent or less frequent during pregnancy
Consequences for mother and newborn
The occurrence of epileptic seizures during the entire pregnancy is accompanied by certain risks for the fetus and mother. Convulsions increase the tone of the uterus and cause oxygen starvation of the fetus. A fall during a generalized seizure can cause premature birth.
Epileptic seizures at an early stage provoke anomalies in the development of the fetus:
- short stature and underweight;
- violation of bone development;
- heart defects;
- facial deformity.
Due to oxygen starvation, there are consequences in the form of mental retardation, attention deficit, speech delay.
Epilepsy is also dangerous for women. Severe cramps lead to placental abruption, which causes severe uterine bleeding. Higher risk of falling and injury.
Women with an established diagnosis of epilepsy need to prepare in advance for the onset of pregnancy. Most anticonvulsants are contraindicated, so the doctor recommends that the woman switch to the safest drug in advance. If against its background the course of epilepsy does not worsen, you can become pregnant.
It is best if conception occurs during the remission of the disease. The absence of absences or seizures within two years is a sign of remission. Conception planning includes:
- normalization of the regime of work and rest;
- creating a favorable psychological environment in the family;
- balanced diet;
- regular walks;
- achieving remission of other chronic diseases;
- rejection of bad habits.
A woman needs to undergo a full examination by a gynecologist in order to identify and cure diseases of the reproductive sphere. Based on the results of the examination, the doctor may prescribe a course of multivitamins to prepare for conception.
During pregnancy, regular consultations with an epileptologist or neurologist are mandatory.
Management of pregnancy
A pregnant woman with epilepsy is observed not only by an obstetrician-gynecologist, but also by a neurologist. Consultations of a narrower specialist – an epileptologist – are desirable. You can not stop taking anticonvulsants. The harm from a relapse of the disease is much greater than from the side effects of drugs.
The plan for examining a pregnant woman with epilepsy includes:
- general clinical tests;
- determination of the electrical activity of the brain;
- ultrasound examination of uterine blood flow;
- assessment of uterine tone.
At a high risk of genetic disorders, a chorion biopsy is performed, a study of amniotic fluid.
To reduce the risks to the baby, the mother needs to take folic acid. It contributes to the full development of the nervous system of the fetus. Against the background of taking anticonvulsants in the mother’s body, the amount of folic acid decreases. Assign it to 4-5 mg per day throughout the first trimester. At a later date, it is permissible to take standard multivitamins for pregnant women.
Features in childbirth
Whether it is dangerous to give birth naturally depends on the severity of the course of epilepsy. In itself, the disease is not an obstacle to natural childbirth. However, a strong load can provoke an attack, then complications arise. An anesthesiologist and a neurologist are present at the birth to provide assistance if necessary.
Childbirth is carried out in accordance with all standards. The preferred method of pain relief is spinal anesthesia. Immediately after birth, the baby is given vitamin K, which improves blood clotting.
The clinical guidelines for epilepsy contain the following indications for caesarean section:
- an increase in the number of seizures by the 30th week of pregnancy;
- incorrect position of the child in the uterus;
- narrow pelvis in the mother;
- signs of oxygen starvation in a child;
- weak labor activity.
An emergency cesarean is done when the mother develops status epilepticus – a series of convulsive seizures during which she does not regain consciousness.
Pregnancy planning and childbirth are carried out under the strict supervision of a physician
Possibility of breastfeeding
Breastfeeding is allowed even when a woman is treated with anticonvulsants. They penetrate minimally into breast milk, so they will not harm the baby. It is recommended to feed in the supine position so as not to harm the baby in case of seizures.
The following activities can help reduce the risk of seizures:
- full sleep;
- balanced diet;
- taking medication;
- regular walks;
- limiting computer use or watching TV;
- limitation of heavy physical activity.
To reduce anxiety before going to bed, it is recommended to take a decoction of lemon balm, chamomile.
Epilepsy is a chronic disease that requires constant use of anticonvulsants. Pregnancy in this disease is not contraindicated, but is carried out under special supervision. The danger to the child occurs when the disease is severe.
Read more: epilepsy in children