Thom visited Tam Anh General Hospital in Ho Chi Minh City last year for a pre-conception health check, having a history of epilepsy. Doctor Nguyen Thi Minh Duc, Head of the Neurology Department at the Neurology Center, explained that certain anti-epileptic medications can pose risks to the fetus, including neural tube defects, cleft lip and palate, blood clotting disorders, heart and spinal defects, and developmental delays. Seizures themselves can cause pregnant women to fall, leading to abdominal injuries, respiratory muscle spasms, or temporary cessation of breathing. These complications increase the risk of fetal distress, hemorrhage, miscarriage, or preterm birth, and can even be life-threatening.

A collaborative treatment plan was developed by specialists from the Neurology and Obstetrics and Gynecology Centers to control Thom's epilepsy while minimizing medication effects on the fetus.

Six months before conception, Doctor Duc advised Thom on an anti-epileptic drug considered safer for pregnancy. Throughout this monitoring period, Thom experienced no seizures, leading doctors to deem her fit for pregnancy. She was also prescribed high-dose folic acid to reduce the risk of neural tube defects in the fetus.

Doctor Nguyen Thi Yen Thu (right), Obstetrics and Gynecology Center, with the team performing a cesarean section for the patient. Photo: Tam Anh General Hospital

According to Doctor Duc, metabolic changes during pregnancy can lower anti-epileptic drug concentrations in the blood, increasing the risk of seizure recurrence. Consequently, Thom underwent regular blood tests and electroencephalogram (EEG) monitoring to adjust her medication as needed.

By the 11th week of pregnancy, an EEG revealed abnormal brain activity. Doctors increased Thom's medication dosage to prevent seizures, ensuring fetal safety.

Doctor Nguyen Thi Yen Thu of the Obstetrics and Gynecology Center noted that pregnant women with epilepsy face a higher risk of preeclampsia, gestational hypertension, gestational diabetes, and congenital abnormalities compared to others. Thom's health indicators were closely monitored, alongside regular prenatal ultrasounds to detect any fetal abnormalities.

During her third trimester, Thom developed polyhydramnios, increasing her risk of preterm birth and postpartum hemorrhage. Her doctors adjusted her nutrition and monitored her pregnancy frequently. At the 38th week, the medical team opted for a planned cesarean section due to the risk of seizures during labor. A healthy baby boy weighing 4.1 kg was delivered safely. Thom continued her epilepsy treatment, ensured adequate sleep, managed stress, and breastfed her baby normally.

Doctor Thu explained that most anti-epileptic drugs are excreted into breast milk at very low concentrations, making infant exposure almost negligible. To minimize the amount of medication the baby absorbed through milk, Thom received guidance on optimal breastfeeding times. If the baby showed signs of excessive drowsiness, fussiness, poor feeding, or slower development compared to peers, a specialist consultation would be necessary.

The newborn boy's health status was assessed by the Neonatal team immediately in the operating room. Photo: Tam Anh General Hospital

Doctor Duc affirmed that women with epilepsy can still have healthy pregnancies and babies with proper disease management before and during gestation. Patients planning pregnancy should seek specialist consultation early, adhere to their medication regimen, and attend follow-up appointments to prevent complications for both mother and child.

Ngoc Chau

*Patient's name has been changed.