Pregnancy

Last updated 19 Jan 2011, review date due 19 Jan 2013

Risks to you and your baby if you have a seizure during pregnancy
Lowering the risks of having seizures during pregnancy
Scans and tests

Risks to you and your baby if you have a seizure during pregnancy

Unborn babies are not usually harmed by their mother having a seizure. However, it’s not ideal for you or your baby if you have seizures when you are pregnant.

There are many different types of epileptic seizure. Some common types of seizure are called partial, absence, myoclonic seizures and tonic-clonic seizures.

Partial, absence and myoclonic seizures should not harm your unborn baby, unless you are injured, for example by falling. There is a very small risk that you or your unborn baby can be harmed if you have tonic-clonic seizures during your pregnancy. However, this risk increases if you have frequent tonic-clonic seizures or status epilepticus (when seizures go on for a long time).

In the UK, about four women with epilepsy die during pregnancy each year. In all pregnancies, there is a small risk that the mother could die. This risk is increased if you have epilepsy. There could be many reasons for this. One possible reason is that some women don’t take their anti-epileptic drugs (AEDs) as prescribed when they are pregnant. This can cause them to have many uncontrolled seizures, which increases the risk of sudden unexpected death in epilepsy (SUDEP).

More information about SUDEP

Lowering the risks of having seizures during pregnancy

Here are some ways you can lower the risk of having seizures during pregnancy.

Before getting pregnant, work with your doctor to try and make sure you have as few seizures as possible. A study has shown that a woman who has no seizures in the nine months before she becomes pregnant is less likely to have seizures in pregnancy.
During your pregnancy, take your AEDs as prescribed by your doctor.
Tell your doctor, midwife and epilepsy specialist about any seizures you have. If necessary, they can make changes to your treatment to try and reduce your seizures.

Scans and tests during pregnancy

In the UK, there are a number of tests, such as scans and blood tests, offered to all pregnant women. Some tests are used to check the mother’s health. Other tests are used to check the baby’s health and growth.

Having epilepsy does not necessarily mean that you will need extra tests to check your health during pregnancy. But if you have more or worsening seizures, a test may be offered to measure the level of anti-epileptic drugs (AEDs) in your blood. This is because the blood level of AEDs can drop during pregnancy. In this case you may be advised to take a higher dose of your AEDs, or an extra AED. Making changes to your AEDs after the first three months of pregnancy won’t increase the risk of major congenital malformations in your unborn baby. This is because your baby will have already developed all of their major organs.

In the UK, all pregnant women are offered ultrasound development scans. These scans check the baby’s health and development. They may detect any problems in a baby, for example a hole in the heart or a cleft palate. You may also be offered blood tests to show the risk of your baby having a condition such as spina bifida.

Whether or not to have tests done to check your baby’s development is your decision. You may choose to have all the tests available, or to have some tests but not others. Scans and tests can be particularly helpful if your baby has a higher risk of having a malformation. They may reassure you about your baby’s health. If they show that your baby has a malformation, your doctor will talk about different options. This may include advice on what help and support you will need to care for your baby. Your doctor may also give you information about ending the pregnancy.