Women, Epilepsy and Pregnancy
While one might not automatically link gender to neurological issues, there are different factors that can make neurological conditions affect only women. Furthermore, there are different neurological conditions that seem to affect women more than men. NorthShore University HealthSystem writes: “While most physicians recognize that there are real differences in managing care for women with neurologic disease, not all specialists place particular emphasis on the interactions and patient concerns associated with pregnancy, breast feeding, birth-control pills and hormones.” Pregnancy and Epilepsy are two things that need balance.
According to the Epilepsy Foundation, women with epilepsy “are at greater risk for complications of pregnancy, labor and adverse pregnancy outcomes than women without epilepsy. Preconceptional counseling and coordination of care among all members of the health care team is key to treating women with epilepsy of reproductive age”. Some ways in which Epilepsy affects women in terms of pregnancy:
-Women with epilepsy have fewer children than women in general, with a fertility rate 25 to 33 percent lower than average.
-research has indicated that women with epilepsy have a higher incidence of menstrual irregularities, polycystic ovarian disease and reproductive endocrine disorders. Any of these may reduce fertility.
-Women with epilepsy taking certain anti-epileptic drugs (AEDs) may experience failure of hormonal birth control methods.
-Uncontrolled seizures, particularly generalized tonic-clonic episodes, are hazardous during pregnancy and discontinuing AEDs may pose a greater risk for both mother and fetus than the possible adverse effects of the medication. Miscarriage, trauma related to falls, fetal hypoxia and acidosis are all possible sequelae of maternal seizures.
-Other potential obstetrical problems seen more frequently in women with epilepys are hyperemesis, gravidarum, vaginal bleeding, and anemia.
- Difficulties during labor and delivery include premature labor, failure to progress, and an increased rate of cesarean sections.
What can be done to prevent complications? NorthShore Hospitals state: “Close to 90 percent of pregnant women with epilepsy avoid complications when their care is properly managed. Careful supervision of drug levels related to pregnancy weight gains, and addition of vitamin supplements help prevent complications during pregnancy”.