New epilepsy in pregnancy guideline published

Yesterday the Royal College of Obstetricians and Gynaecologists published the first edition of a new guideline concerning epilepsy and pregnancy.

It is hoped that the guideline will help women with epilepsy make more informed choices during pregnancy, and allow health care professionals to provide better care for these women.

Lead Author, Professor Shakila Thangaratinam, at Barts and The London School of Medicine and Dentistry, said: “It is important that these women receive preconception counselling, meet with an epilepsy specialist, and are monitored closely for seizure risk factors. Their adherence to antiepileptic drugs, seizure type and frequency during the antenatal period should also be closely assessed.”

Women with epilepsy are classified as high risk during pregnancy, and therefore it is important that they receive specialist medical advice even before becoming pregnant, or as soon as possible after finding out that they are pregnant. According to Professor Shakila Thangaratinam, they should also receive multi-disciplinary care throughout their pregnancy.

The new guideline states that specialist care should continue throughout pregnancy and into labour, and that women who are at risk of seizures during labour should give birth in consultant-led units with facilities for one-to-one midwifery care.

It also offers advice on the taking of antiepileptic drugs (AEDs) in pregnancy, stating that expectant mothers should be prescribed the lowest possible dose of the most effective AED (because completely stopping medication can cause more harm to both mother and baby).

According to the guideline, women with epilepsy should take a higher daily dose of folic acid supplements than usual to reduce the possible harm AEDs might cause to their baby (please note that you should always seek medical advice before taking any supplements).

Finally, the guideline advises that women with epilepsy should receive extra care following birth, and that they should be carefully monitored for signs of post-natal depression and anxiety. Post-natal care could also minimise the risk of seizures linked to tiredness, sleep deprivation, and stress.

It is estimated that 2,500 babies are born to mothers with epilepsy each year in the UK. Between 2009 and 2013, 21 pregnant women died as a result of epilepsy.

The full report can be accessed here.

Author: Dr Özge Özkaya

Click here for more articles about anti-epileptic drugs and pregnancy risks.

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