Seizure disorders can affect fertility. However, certain anticonvulsants may reduce the effect of oral contraceptives and lead to an unintended pregnancy.
(Seizure disorders.) Seizure disorders can affect fertility. However, certain anticonvulsants may reduce the effect of oral contraceptives and lead to an unintended pregnancy. The dose of anticonvulsant drugs may be increased during pregnancy in order to maintain the therapeutic level. When the pregnant women get enough sleep and levels of anticonvulsant drugs are kept within the therapeutic range, the seizure frequency does not rise during pregnancy generally, and the course of pregnancy is undisturbed. Risks for preeclampsia, growth restriction and stillbirth are slightly increased. In general, uncontrolled seizures during pregnancy are more harmful than the use of anticonvulsants; therefore, the control of seizures in the treatment during pregnancy has top priority. Before designing a neurologist should be consulted in order to stabilize the maternal seizures before pregnancy. Physicians should administer the lowest possible dose of anticonvulsants and as little as possible different anticonvulsants. Congenital malformations are more common in fetuses of women with seizure disorders (6-8%) than in the fetuses of healthy women (2-3%). The risk of mental retardation can also be increased. These risks may be associated with both the seizure disorders as well with the use of anticonvulsant drugs. The risk of a bleeding disorder of newborns (erythroblastosis neonatorum), by the intrauterine exposure to certain anticonvulsant drugs (such. As phenytoin, carbamazepine, phenobarbital) may be increased. However, if vitamins are taken with vitamin D in pregnancy and the newborn Vitamin K is given, a blood disorder is rare. The intake of phenobarbital during pregnancy can reduce the physiological neonatal jaundice, perhaps because the drug stimulates the conjugating liver enzymes. Generally Phenytoin is preferred. All anticonvulsants increase the need for folic acid substitution; 4 mg p.o. is 1 times given / day. Ideally, so pregnancy is begun before entering. A vaginal delivery, preference is usually given, but if the pregnant women during labor have repeated seizures, a cesarean section is indicated. The blood levels of anticonvulsant drugs often change after birth very quickly and should then be closely monitored.