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Epilepsy and Pregnancy: Keeping Your Baby Healthy

Epilepsy Epilepsy Basics

Planning for Pregnancy When You Have Epilepsy

Summary & Participants

Epilepsy does not have to stand in the way of a pregnancy. The best way to ensure a safe and healthy baby is to discuss your treatment options with your doctor.

Medically Reviewed On: July 06, 2008

Webcast Transcript

ANNOUNCER: Epilepsy and seizures affect approximately one million women of childbearing age in the United States. And the chances are very good that a woman with epilepsy will give birth to a healthy baby, and a well-planned pregnancy can reduce the risk of complications.

TRACY GLAUSER, MD: Women with epilepsy do have a higher rate of difficulty getting pregnant, and they also have a higher rate than the general population of having children with some birth defects. It is important to know that the vast majority of children born to women with epilepsy are perfectly healthy and grow up to be perfectly normal.

ANNOUNCER: The best way for a woman with epilepsy to avoid any seizure-related complications, is to discuss and plan her pregnancy with her doctors.

CYNTHIA HARDEN, MD: A woman with epilepsy should prepare and plan for her pregnancy for several reasons. The first and most important reason is that she should not have generalized seizures and preferably no seizures during her pregnancy. It's been shown that they can decrease fetal heart rate and increase the risk of miscarriage. Also just in general, trauma during pregnancy of whatever cause but including falling during a major seizure can really put the pregnancy at risk and cause miscarriage, basically, due to rupture of the placenta from the uterus.

ANNOUNCER: Another reason that a woman with epilepsy needs to plan her pregnancy, is that anti-epileptic medications have been associated with an increased risk of birth defects.

CYNTHIA HARDEN, MD: We do not have a specific anti-seizure medicine at this time that has been shown to be completely safe during pregnancy. The types of birth defects that are associated with anti-seizure medicines are the same as in the general population, and these include the most common sorts of birth defects, like cleft lip, cleft palate; also cardiac defects, holes in the heart, so to speak, or other malformations of the heart; and then spinal cord defects, specifically lack of closure of the lower spinal cord.

ANNOUNCER: Not all anti-seizure medications are associated with all of these birth defects. And there is some evidence that the newer anti-epilepsy drugs pose less risk, although more data is needed.

CYNTHIA HARDEN, MD: There seem to be several that have emerged as possibly being worse than the others. This would include Depakote†, which appears to have a higher risk of the spinal cord defects, and phenobarbital, which recently has been reported to have a higher-than-expected rate of birth defects associated with it and these are largely cardiac.

Outside of these two medications, it's not clear that any of the others are that much different. In addition, with a whole new generation of anti-seizure medicines, although they've been widely used throughout the world, we still don't have enough information to clearly counsel our patients.

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