Most people with epilepsy or seizures during pregnancy will have a normal pregnancy and a healthy baby. It is important, though, that people take steps to manage any potential risks of seizures during pregnancy.
This article looks at first-time seizures and epilepsy during pregnancy, treatment, and how to manage potential risks.
According to a 2020 article, first-time seizures during pregnancy are quite rare.
A first-time seizure in pregnancy may indicate epilepsy, or it can be due to other factors.
Other possible causes of first-time seizures during pregnancy include:
- a complication of eclampsia
- sleep deprivation
- hormonal changes
A first-time seizure may develop into epilepsy, but it is unclear how commonly this occurs or if seizures will reoccur with further pregnancies.
If a person has a seizure during pregnancy, it is important for someone to
While waiting for professional medical attention, there are some steps people can take to help someone who is having a seizure.
These depend on the type of seizure a person has, but generally, people can help by:
- remaining calm
- checking the person to see if they have any emergency information, such as a medical bracelet
- staying with them until the seizure ends and the person is fully awake and conscious
- bringing the person to a safe place to sit down
- simply communicating what has happened once the person can understand
Most seizures during pregnancy occur due to preexisting epilepsy. Pregnancy may affect the severity of seizures, as well as how frequently they occur. This can be due to:
- hormonal changes
- changes in antiseizure medication
- changes in how a person can stick to a medication regime due to morning sickness
- sleep deprivation
Some people find that seizures worsen in pregnancy, while others find seizures stay the same or improve.
If a person with epilepsy is planning to become pregnant, it is important they speak with a healthcare professional to help plan the pregnancy.
Most people with epilepsy will have a normal pregnancy and a 90% chance of delivering a healthy baby.
There is a slightly increased risk of congenital abnormalities due to antiseizure medications, injury from a seizure, or genetic conditions.
A doctor may prescribe certain antiseizure medications that are safe to take during pregnancy.
The drugs lamotrigine and levetiracetam may be safer to use during pregnancy than other antiseizure medications.
Some antiseizure medications may not be suitable during pregnancy. Sodium valproate may increase the chance of congenital abnormalities or developmental and learning difficulties in the baby.
The risk can be greater in people who are taking topiramate primarily to treat epilepsy, which may be due to higher doses.
Steps to help manage epilepsy with pregnancy include:
- discussing anti-epileptic drugs (AEDs) with a doctor, who can suggest a change in medication type or dosage, as well as monitoring levels of AEDs in the blood
- taking any AEDs as a doctor prescribes
- taking folic acid before and during pregnancy, which may help prevent congenital problems
- attending all prenatal checkups and any visits with neurologists and obstetricians
- reporting any changes in seizures to a doctor
During pregnancy, a person may require a higher dose of AEDs than usual to prevent seizures, particularly if they are taking lamotrigine.
Seizures during pregnancy pose significant maternal and fetal risks.
A person with epilepsy who becomes pregnant is at a substantially increased risk of adverse outcomes, including preeclampsia, preterm labor, stillbirth, and cesarean delivery.
According to the Epilepsy Society, there is no evidence to suggest that the following seizures cause any harm to a fetus:
However, a 2018 review found that having seizures during pregnancy poses a risk to the pregnant person and the fetus.
Additionally, if any seizure causes injury, it can pose a risk to the pregnant person and the fetus.
Tonic-clonic seizures can potentially cause a miscarriage or harm the pregnant person. A person with tonic-clonic seizures can reduce this risk by taking medication appropriately and discussing management with a doctor.
Additionally, some antiseizure medications may pose a risk to the fetus as they can pass through the placenta and affect how the fetus develops.
Taking steps to minimize or prevent seizures during pregnancy can help to reduce any potential risk to the fetus.
This section answers some common questions about seizures and pregnancy.
Can a seizure cause a miscarriage?
Additionally, seizures that cause a person to fall and injure themselves can pose risks to a fetus.
However, treatment to help people stay as seizure-free as possible during pregnancy may help reduce the risk of miscarriage or harm to a fetus.
2019 research suggests that in most cases, with seizure management, people with epilepsy can stay seizure-free during pregnancy or have well-controlled seizures with no change in their frequency.
What does a seizure feel like in pregnancy?
How a seizure feels during pregnancy may depend on the type of seizure a person has.
In general, a seizure may make people:
People with epilepsy may find that the frequency of seizures alters during pregnancy, or it can stay the same.
A person may experience first-time seizures during pregnancy due to hormonal changes, eclampsia, or sleep deprivation. In some cases, a first-time seizure in pregnancy can be the first sign of epilepsy.
It is important for a person to talk with a doctor before and during pregnancy if they have seizures. Antiseizure medications may help people control seizures, which can lead to better pregnancy outcomes.
Although seizures during pregnancy may come with some risk to the pregnant person and fetus, most people with epilepsy will have a safe pregnancy with a high chance of delivering a healthy baby.