At the moment, epilepsy is a well-studied and cured disease, there are many modern antiepileptic drugs. Fortunately, epilepsy is rare. To date, an unexplored issue for doctors remains the management of pregnant patients suffering from this ailment. Can they create a full-fledged family, give birth and bring up children? What difficulties are they waiting for?
Epilepsy is a chronic disease of the brain, which is characterized by repeated seizures. Synchronous violation of the electrical activity of the brain is manifested by a change in consciousness and motor or sensitive symptoms, resulting in a classic attack. It is characterized by convulsive contractions of the muscles of the limbs and trunk, while the patient falls to the ground, often bites the tongue, foam appears from the mouth. After an attack, involuntary urination is sometimes noted.
Such seizures can cause interruption of pregnancy or oxygen deficiency of the fetus (hypoxia). But more dangerous are generalized seizures (large convulsive seizures), since during such attacks there is a high probability of injuries, including the stomach. As a result, it can lead to abruption of the placenta and a violation of uteroplacental blood circulation. Seizures that are characterized by the absence of seizures, in turn, do not affect the growth and development of the fetus.
Preparing for pregnancy
A woman suffering from epilepsy can feel completely adapted to society, apart from the fact that she needs to regularly take antiepileptic drugs and adhere to the regimen (good sleep , exclusion of alcoholic beverages). Observance of these rules gives the woman the opportunity to feel herself a full member of society, she has a desire to become a mother.
If a woman is sick with epilepsy, then she must come to the pregnancy consciously. Treatment of this disease is carried out by a qualified epileptologist constantly, beginning with the period of puberty. Drug therapy can be abolished if there were no seizures on the background of taking medication.
Epilepsy occurs in 1% of the total population, of which more than 40% are women of childbearing age. According to other sources, of all pregnant women, about 1% of women are sick. In some women, the disease first appears during pregnancy, this is the so-called gestational epilepsy. Regular reception of epileptic drugs can get rid of bouts of the disease.
Observations of pregnant women with epilepsy
With regular medication and remission of epileptic seizures, the neurologist should be monitored once every 2 months, and the obstetrician-gynecologist - according to the regulations. It is important to know that you need to apply to the epileptologist for any increase in seizures, the causes of which may be a violation of the drug regimen, lack of sleep, somatic pathology.
In case of frequent seizures, the EEG study and the determination of AEP concentration are carried out at each treatment of the pregnant woman to the neurologist. In the absence of attacks - 1 time in 2 months.
When the pregnant woman is registered, on 19-21 week and further 1 time in 4 weeks dynamic dynamic examination of the fetus is carried out. It is necessary to exclude anomalies of fetal development.
Given the risk of acquiring a congenital pathology, it is mandatory to consult a geneticist before the 17th week of pregnancy. If necessary, an additional chorion biopsy is performed, a cytogenetic study.
Cardiotocography is prescribed from the 26th week of pregnancy for an objective evaluation of the parameters of uterine motility and fetus status. With an even flow of epilepsy, there is no special prenatal preparation.
Peculiarities of the birth and the postpartum period
With epilepsy, labor can be carried out through the natural birth canal. Caesarean section is necessary in the event that the number of epileptic seizures in the prenatal period has increased and negative dynamics of fetal development is observed. Drug management for epilepsy does not differ from usual.
Doctors strongly recommend taking anti-epileptic drugs on a regular basis and observe a rest regime, as there is a risk of exacerbation of the disease in the postpartum period.
The appearance of drowsiness, ataxia, nystagmus in a woman requires a study of the concentration of AED. The increased concentration of drugs is due to a decrease in the total body weight of the mother and the blood loss during childbirth, resulting in the intoxication of AEP. As a rule, in the postpartum period it is enough to return to the daily dosage, which was applied before pregnancy (if during the pregnancy this dose increased).
Experts recommend immediately after birth to lead the child intramuscularly vitamin K at a rate of 1 mg per 1 kg of weight.
Do not give up breastfeeding, because during pregnancy the probability of getting an AED in the blood of a child is much higher than with the mother's milk. To feed it is necessary in a supine position that in case of development of a seizure to avoid a trauma.
Is it dangerous to use antiepileptic drugs during pregnancy?
All antiepileptic drugs can cause malformations of the fetus, but generalized seizures are even more harmful to the development of the child than the AEP. When using these drugs, a minimum daily dose with controlled release of the active substance is prescribed. In no case should you stop taking AEP during pregnancy because of the high likelihood of developing generalized seizures or epileptic status (seizures follow one after another). When a woman learns of pregnancy, it has been some time before, for which he managed to exert his influence, therefore, to refuse the use of AEP should not.
As a rule, most women with epilepsy have pregnancy and childbirth without complications - and they have a normal healthy child. Negative consequences are reduced to a minimum, if you regularly visit a doctor and take care of your health.