Prior to pregnancy
There are steps that you can take to decrease the risks for the baby and for you.
• Plan your pregnancy! Discuss your plans with your obstetrician/gynecologist and with your neurologist/epileptologist as early as possible. It is never too early! Women usually find out that they are pregnant in the fourth to sixth week of pregnancy. By that time the harmful effects of antiseizure medications would have already occurred.
• Prior to your pregnancy your neurologist/epileptologist will consider:
- Reducing your medications to single medication (monotherapy)
- Changing your medication
- Decreasing dose of your medication
- Stopping your medication
• Women who have better seizure control prior to pregnancy usually have fewer seizures during pregnancy. Work closely with your neurologist to achieve seizure control. Once medications are adjusted, a baseline level of medication will be obtained – this will be your target level during pregnancy.
• Folic acid has a protective effect for the baby. Some antiseizure medications may deplete the body from folic acid. Take extra folic acid (1-4mg per day) while trying to conceive. This will decreases the risk of neuronal tube defects in baby which are formed early in pregnancy (24-28 days after conception) when most women don’t even know that they are pregnant.
• Take prenatal vitamins while trying to conceive.
• Discuss the possibility of genetic counseling, especially if there is a history of birth defects in family.