Suffering from epilepsy and continuing with a pregnancy is a situation that occurs in 3 cases out of 1,000. It is not the most frequent, but neither can it be said that they are a marginal number of cases.
Luckily, seizures are not increased by the fetus, nor are there any abnormalities in most children born to mothers with the disease. Up to 96% reach maturity with a normal deliverywithout complications.
What happens in a pregnant woman with epilepsy?
Epilepsy is defined as a neurological disease in which the person suffers from massive, synchronous firings from their own neurons. That is, the electrical activity of nerve cells occurs simultaneously in large areas of the brain.
This may or may not result in seizures. There is a difference between epileptic seizures and convulsive status. They don’t always go hand in hand, although in popular thought they are. In any case, the electric shock is always expressed with some symptoms, which can be an absence or a small localized movement.
During pregnancy, the female body changes due to the action of hormones, especially progesterone. There are changes in the genital, reproductive, cardiac and soft tissues in general. We could say that almost all cells are affected in one way or another.
There was no significant increase or decrease in seizures during pregnancy. THE epidemiological studies in this regard they conclude that this type of influence cannot be attributed to the fetus.
However, more serious problems have been reported when the pregnant woman is not getting adequate sleep due to insomnia. In general, crises increase if the Lack of sleep It focuses on the last quarter. However, it is not known for certain whether the final culprit is poor rest, stress or the hormonal factor as such.
Now, there are problems with the concentration of drugs used to treat epilepsy. Let’s remember that pregnant women with epilepsy are already on therapy, and pregnancy changes the total volume of circulating blood, as well as its distribution in body tissues.
Antiepileptic drugs during pregnancy
Regularly prescribed anticonvulsant drugs have congenital malformations as an adverse effect. This presents a dilemma when it comes to assisting and monitoring a pregnancy in a woman with epilepsy.
If we compare the incidence of birth defects Among children born to epileptic mothers versus others to women without the disease, we found striking differences. While in the general population one malformation appears every 100 deliveries, in those treated with antiepileptics the risk is up to 3 times greater.
The likelihood of a complicated delivery increases when the mother’s prescribed medications are different. This is a frequent situation among epileptic patients who do not respond well to usual treatments and the doctor begins to combine different doses to reduce seizures.
In polytherapy, which is the administration of several drugs at the same time, congenital malformations were detected when drugs such as valproate and carbamazepine were included. In the fetus, the most affected is its central nervous system.
What doctors suggest when a woman plans a pregnancy is the reduction of antiepileptic doses at safe points. Sometimes very small amounts of a single drug may be used if the patient has been seizure-free for more than 9 months.
Anyway, This reduction can only be carried out by a doctor or specialist. Neither the patient, nor his relatives, nor anyone lacking the necessary faculty can make this decision, since the risk of missed administration is high and the consequences are serious.
Is there a risk of seizures during pregnancy?
although the statistics they don’t clearly signal an increase or decrease in seizures during pregnancy, the truth is that they do happen. If the patient has had frequent seizures, she will continue to do so throughout her pregnancy.
Seizure states pose risks to the mother and fetus. One of the major problems is hypoxia, i.e. the lack of oxygenation of the tissues while the event is taking place. If enough gas doesn’t reach the placenta, the baby can have problems with the functioning of its developing organs.
Similarly, trauma is a complication of seizures that becomes problematic in a pregnant woman. Losing consciousness during the episode, the patient may fall and injure sensitive areas, such as the skull and abdomen, now enlarged by the uterus holding the fetus.
THE mortality rate in epileptic pregnant women it is higher than in the rest of pregnant women. Many of these deaths, estimated at about 1 in 1,000 pregnancies, are attributed to sudden unexpected death in epilepsy (MSIE).
THE MSIE extension It is a death with no apparent cause, without drowning or trauma, in people with epilepsy. The origin of the syndrome is unknown, but it is known that there are risk factors that can be acted on to reduce the possibility of its occurrence.
The woman should never sleep alone, nor should she sleep face down. Also, as much as possible, your family or friends should be trained in first aid to assist you.
What to remember about pregnancy and epilepsy?
A pregnancy can be combined with the condition epilepsy. It’s not an impossible task, but it does require close supervision by the treating physician and the taking of precautions that reduce the associated risks.
Medications are continued as prescribed by professionals. You may be required to do this concentration dosages of them in the maternal blood to regulate the amounts. The pregnant woman should never make her own decision to stop or change the dose.
The birth must be planned in advance, in specialized places, with a medical team that has experience in the field. The Caesarean section option is valid and should arise from a sincere dialogue between the obstetrician and the woman. The greater the communication between the parties involved, the better the results obtained at the end of the whole process.
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