Which AEDs have the greatest risks?
Information on our brand-new anti-epileptic medications is scarce, and information on the original anti-epileptic medications is scarcer still. Given the information available, it is advised to use the medication with the fewest side effects and the greatest effectiveness.
Pregnancy registries have been established to help gain information. Prior to the initial pregnancy screening, all pregnant epileptic women are encouraged to sign up for the North American Anti-Epileptic Drug Pregnancy Registry in order to advance our body of knowledge. Through their neurologist, women outside of North America are urged to sign up for their pregnancy registry.
While the majority of our anti-epileptic medications can be used safely, some have higher specific risks.
Can seizures affect an unborn baby?
There is no evidence that the activity associated with absence, myoclonic, or focal aware (previously known as simple partial), focal impaired awareness (previously known as complex partial), seizures is harmful to an unborn child. However, there are risks involved if you hurt yourself while having a seizure of any kind. Tonic-clonic seizures may result in miscarriage or serious harm to both you and your unborn child. Rarely, epileptic women have lost their lives while carrying a child, usually as a result of inadequate seizure control.
The goal is to keep you as seizure-free as possible throughout your pregnancy to minimize any risks to you and your unborn child. It can be beneficial to take your AEDs as directed and notify your doctor or midwife if you experience any seizures.
Can AEDs affect an unborn baby?
Because the baby won’t come into contact with the father’s AEDs, if the father has epilepsy and takes them, this won’t have an impact on the baby’s development.
If a pregnant epileptic woman uses an AED, the baby will be exposed to the drug while still inside the mother. Although a mother’s bloodstream and that of her unborn child are kept separate while she is pregnant, some substances can cross the placenta and enter the blood of the child. These substances include nutrients, oxygen, alcohol and medication, including AEDs. During the first 12 weeks of pregnancy, when the baby’s major organs and skeleton are developing, some AEDs can have an impact on how the baby grows and develops inside the womb.
See more about birth abnormalities and reducing the risk.
Pre-natal screening refers to a variety of tests that all pregnant women undergo to determine how their child is growing inside the womb. These include the ultrasound exams that are performed throughout the course of pregnancy at specific intervals, most frequently at 12 weeks (known as the dating scan) and at 18 to 20 weeks (known as the anomaly scan).
Additionally, combined blood tests measuring a variety of factors, such as levels of alphafetoprotein (AFP), are provided to women. AFP is a type of protein that is transferred from the mother to the unborn child. The amount of AFP in a mother’s blood can help predict the likelihood that her unborn child will have certain conditions, such as spina bifida. A baby cannot be guaranteed to be born with or without any birth abnormalities based solely on screening. However, it can be used to estimate the likelihood that a baby will have a birth defect.