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Epilepsy and pregnancy in Kenya

Epilepsy and pregnancy are one of the widely discussed topics in women health. Becoming pregnant when you have epilepsy is risky. Getting women health expert to guide and advise you, can work in your favor.

Epilepsy and pregnancy

How do you manage Epilepsy and pregnancy today? It is one of the issues that raises concerns during seizure medication. Become safe today by going through the article.  

What you need to know about epilepsy and pregnancy?

Epilepsy is a relatively common disorder occurring in 0.15 to 1 percent of women of child bearing age.

Pregnancy has no consistent effects on epilepsy and although several studies have shown an increase in the frequency of fits, others have shown no difference or a decrease in their frequency. Women who are fit free for many years are unlikely to fit in pregnancy unless they discontinue their medication. If the epilepsy had been poorly controlled prior to pregnancy then the mother is more likely to deteriorate in pregnancy.

In the majority of cases, most women have been diagnosed and are already on anticonvulsant therapy prior to pregnancy. Many factors contribute to altered drug metabolism in pregnancy and result in a decrease in anticonvulsant blood drug levels. These include

  • Reduced compliance because of fears of adverse drug reactions to the fetus resulting in congenital malformations ( i.e. an abnormal pregnancy)
  • Nausea and vomiting especially in first trimester
  • Increase in blood volume
  • Increase in fluid in the tissues
  • Reduced amount of protein in the blood that would bind and carry the drug, hence resulting in most of the drug being cleared from the body

Lack of sleep towards term and in labour may also contribute to deterioration of epilepsy in pregnancy.

What are the complications during pregnancy when you have epilepsy?

A number of complications have been associated with epilepsy

  • Vaginal bleeding during and after pregnancy
  • High blood pressure in pregnancy
  • Preterm delivery
  • Low birth weight babies

The principal concern related to epilepsy in pregnancy is the increased risk of congenital abnormality. All anticonvulsant medication has been associated with fetal abnormality. Many of these abnormalities are detectable by ultrasound and therefore all women should be offered the option of an expert scan.

Despite the risks of anti-epileptic medication (said to be about 2 percent), failure to do so may lead to an increased frequency of epileptic fits resulting in both maternal and fetal suffocation due to lack of oxygen. It is very important for the mother on anti-epileptic medication to know that uncontrolled seizures are more harmful to the baby than the potential risks of drug therapy.

Despite a fall in drug levels in pregnancy, most women don’t experience increased fits.

Other causes of fits in pregnancy include

  • High blood pressure disease in pregnancy
  • Meningitis
  • Brain tumour
  • Drug and alcohol withdrawal
  • Drug overdose
  • An imbalance in one’s metabolism, for example, low blood sugar, low sodium or low calcium in the blood

What is the postnatal care for epilepsy and pregnancy cases?

In the postnatal period, mothers may suffer from a marked loss of sleep as they take care of the newborn child, which may predispose to fits. It is important for mothers to be very compliant to medication at this time. There are no contraindications to breast feeding and may facilitate drug withdrawal in the babies. Mothers should be watchful for signs of sedation and poor feeding.

How should I prepare for pregnancy?

Patients at risk should therefore

  • Have preconception counseling, purpose of which are to emphasize compliance and to achieve control of the epilepsy with a single drug (this is because of their potential to cause congenital abnormalities)
  • Take daily folic acid supplementation three months before and throughout pregnancy
  • Never take a bath unattended
  • Never drive
  • Have adequate sleep and avoid other precipitating factors like noise and disco lights
  • Maintain follow up for up to 3 months after delivery to ensure they are seizure free and to reduce drug dosages as necessary.
  • Avoid hormonal contraception after delivery. This should only be prescribed by the physician who’ll adjust the dosage or frequency of the contraception as appropriate.

Partners or other family members should know how to manage a seizure and, in particular, be aware of the importance of the recovery position. Epilepsy and pregnancy can be handled well if you talk to a gynaecologists in Kenya. Alternatively you can contact Velvet Health for help.

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