Hesperian Health Guides
Pregnancy complications
HealthWiki > Epilepsy and Seizures > Chapter 7: Pregnancy and birth with epilepsy > Pregnancy complications
To protect your health and the baby’s health, take your antiseizure medicine every day, get regular checkups, rest often, eat nutritious food, and avoid alcohol and tobacco. If something does not feel right, talk with a midwife or other health worker. Reaching out sooner rather than later can make a big difference.
Contents
Seizures during pregnancy
Seizures during pregnancy may cause physical injuries, which may also prevent oxygen from reaching the baby in the womb. Try to avoid situations that trigger your seizures. This can be difficult because common physical and mental changes caused by pregnancy are seizure triggers for many people.
Changes in sleeping patterns
Growing a baby is hard work, and it can be difficult to get enough rest. Feeling anxious about a pregnancy and becoming a parent can also be tiring. As your body size increases, it may be difficult to find a comfortable sleeping position. Try to get as much rest as you can, especially if lack of sleep is a seizure trigger for you.
Body changes during pregnancy
The amount of blood in the body increases during pregnancy, and the heart, liver, and kidneys all work harder and faster. These changes can cause your body to clear seizure medicine more quickly, lessening the amount of medicine in your blood to a level where it may no longer control seizures. Pregnancy can also change how your stomach and intestines absorb medicine, especially if vomiting increases. Increases in body weight can affect how well your dose of antiseizure medicine works to control your seizures.
Regular checkups can allow your dose of antiseizure medicine to be adjusted so it continues to prevent seizures.
Physical injury from falls during seizures
The risk of injury from falls during pregnancy is high, especially for people whose seizures are not well-controlled. Some injuries caused by a fall may be easy to see, such as a cut or a bruise. But when an injury happens inside the body, it may not be visible. These injuries can cause internal bleeding or harm the baby growing in the womb.
WARNING! If you suspect internal injuries or if any of these signs are present, get the person to a medical center immediately:
- heavy and continuous vaginal bleeding
- abdominal pain after seizure ends
- dizziness, tiredness, or difficulty breathing
Pre-eclampsia
Pre-eclampsia is a serious high blood pressure problem that happens later in pregnancy, during labor, or a few days after birth. If not identified and treated, pre-eclampsia can lead to eclampsia, which causes seizures (a different type than epileptic seizures) and can cause death.
While most people with eplepsy do not get pre-eclampsia, they do have a higher risk of getting pre-eclampsia than people without epilepsy. Blood pressure should be measured at all pregnancy checkups, whether a person has epilepsy or not. High blood pressure can be a sign of pre-eclampsia.
SIGNS
Pre-eclampsia
High blood pressure Healthy blood pressure is between 90/60 and 140/90 and does not go up much during pregnancy. High blood pressure is when the top number is above 140 and the bottom is over 90.
Protein in the urine. Test strips (brand names: Uristix, Albustix, Labstix, and others) change color when they measure too much protein in urine. Check the date on the box to make sure the test strips are not expired.
A pregnant person with high blood pressure and any of these signs probably has pre-eclampsia and needs help at a medical center:
- strong headaches that do not go away with medicine
- vision changes such as spots, blurriness, or double vision
- steady, severe pain in the top of the belly or the right side under the ribs
- overactive reflexes
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To check for overactive reflexes, have the person lie down and hold their foot like this Give a quick push, then let go. |
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If the foot jerks 2 times or more, it is an overactive reflex. This is a danger sign. |
On the way to a medical center, have the pregnant person lie on their left side. Someone should accompany them in case they have a seizure.
Preventing pre-eclampsia
A low-dose aspirin (75 mg or 81 mg) taken daily can help prevent pre-eclampsia. Activities and habits that help keep blood pressure in a healthy range also support prevention. For example:
- Eat vegetables, fruits, legumes, and whole grains rather than highly processed, salty, or sugary “junk” foods.
- Limit the amount of salt you eat.
- Get 30 minutes of light to moderate physical activity every day.
- Try to avoid stress.
A person with pre-eclampsia is often told to rest in bed for the rest of their pregnancy and avoid physical activity that might cause early labor or trigger eclampsia.
Eclampsia is an emergency!
When pre-eclampsia turns into eclampsia, this is an emergency! Eclampsia is when a person suddenly has a seizure. It may happen during the final weeks of pregnancy, during labor and birth, or up to 6 weeks after delivery.
Eclampsia seizures look like tonic-clonic epileptic seizures—a person may have jerking movements, their body may shake, or they may fall to the ground unconscious. But epilepsy and eclampsia are different health conditions.
Eclampsia seizures can cause physical injury, stroke, heart failure, and death, both for the mother and the baby. A person with an eclampsia seizure may deliver a baby too early (preterm or premature birth). When an eclampsia seizure stops oxygen from getting to the baby, the baby can die.
Treating eclampsia
A person with eclampsia needs emergency treatment in a medical center immediately. Place them on their side to prevent them from inhaling their vomit. Immediately stop the seizure by giving magnesium sulfate through IV (in the vein) or IM (in the muscle) injections in the buttock. If magnesium sulfate is not available, give Epilepsy_and_Seizures:Rescue_medicines_for_status_epilepticus#diazapamdiazepam instead. For information on how to give emergency medicine during a seizure, see Chapter 4.
Placenta complications
The placenta is an organ that grows in the uterus during pregnancy. It provides the baby with all their oxygen and food and removes waste. Some placenta-related complications are a little more common in pregnant people with epilepsy.
Placental abruption is where the placenta separates from the uterus too early. It may happen when a seizure causes an injury from a fall. Controlling seizures can prevent placental abruption.
Placenta previa is where the placenta attaches too low in the uterus and covers the cervix. It may be found during a checkup with an ultrasound (sonogram), a machine that uses sound waves to show the inside of your body and the baby in the womb. Or it may be diagnosed by bright red painless bleeding from the vagina after about 20 weeks of pregnancy, the main sign of placenta previa. If you have placenta previa, you will need to rest more, avoid heavy lifting and vaginal sex, and plan a hospital Cesarean (C-section) birth (the surgical delivery of the baby through a cut made in the abdomen and uterus).