Management and Care of Epilepsy During Pregnancy, Birth and Postpartum

Epilepsy is a common chronic neurological disorder that affects 0.5% of women in reproductive age. This health condition can cause pregnancy complications and vital problems in terms of mother, fetus and newborn. Therefore, the management of epilepsy is of special importance in preconceptional, pregnancy, birth and postpartum periods. It is suggested that epileptic women planning
pregnancy, especially who are using antiepileptic drugs (AED,) should start to use adequate dose of folic acid 2-3 months before pregnancy because of the risk of neural tube defects. In order to have a healthy pregnancy for both mother and fetus, using prenatal screening and diagnostic tests, appropriate monotherapy drug selection, control of seizures, education and counseling on routine pregnancy
monitoring and care would be appropriate. The AED regime must be maintained regularly in the innatal period. There is no problem for the vaginal deliveries of epileptic pregnant women. However, literature suggests that cesarean birth is preferred. K vitamin supplements should
not be forgotten due to the risk of hemorrhage in infants of epileptic mothers using AED. Although many AED’s pass from mother to baby, it is stated that they are not harmful to the baby and there is no contraindication to breastfeeding. For this reason, nurses support and counseling for breastfeeding mothers is very important in the postnatal period. In order to avoid triggering postpartum seizures, epileptic mothers have a greater need for sleeping, resting, nutrition, and support systems compared to other postpartum populations. This support should also be maintained in relation to neonatal care. Postpartum hormonal contraceptives for epileptic women should not
be the first choice because of the interaction with AEDs. In this article, the importance of preconceptional care in
epilepsy, prognosis of epilepsy during pregnancy, its effects on pregnancy, fetus and neonatal health, management of epilepsy in prenatal, innatal and postnatal periods are discussed in the light of literature.