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Pregnancy Week by Week : Week 26 (part 4) - Seizures and Epilepsy

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Using Retin-A

Retin-A (tretinoin), not to be confused with Accutane (isotretinoin), is a cream or lotion used to treat acne and to help get rid of fine wrinkles on the face. If you are pregnant and using Retin-A, stop using it immediately!

We don’t have enough data to know if it’s safe to use during pregnancy. We do know any type of medication you use—whether taken internally, inhaled, injected or spread on the skin—gets into your bloodstream. Many substances in your bloodstream can be passed to your baby.

Some medicines a mother-to-be uses become concentrated in baby. Your body can handle it, but your baby’s body may not be able to. If some substances build up in the baby, they can have important effects on its development. In the future, we may know more about the effects of Retin-A on a growing baby. At this time, it’s best to avoid using it for the sake of your baby.

Seizures and Epilepsy

A history of seizures—before pregnancy, during a previous pregnancy or during this pregnancy—is important information you must share with your healthcare provider. (Another term for seizure is convulsion.) It’s estimated that about 500,000 women in the United States with a seizure disorder are of childbearing age.

Seizures can and usually do occur without warning. A seizure indicates an abnormal condition related to the nervous system, particularly the brain. During a seizure, a person often loses body control. This can be serious for mom and baby.

Be sure you get enough sleep. Sleep deprivation can cause more seizures.

If you have never had a problem with seizures, know that a short episode of dizziness or lightheadedness is not usually a seizure. Seizures are usually diagnosed by someone observing the seizure and noting the symptoms previously mentioned. An electroencephalogram (EEG) may be needed to diagnose a seizure.

Epilepsy. If you have epilepsy, it’s important to control your disease during pregnancy because seizures can affect you and baby in many ways. One-third of women with epilepsy will see a decrease in the number of seizures they have during pregnancy. One-third will have more seizures, and one-third will see no change at all.

During pregnancy, hormonal fluctuations can affect epilepsy. You may be at higher risk of some pregnancy problems. Grand-mal seizures can put the baby at risk because they reduce blood flow to the fetus.

Seizures seldom occur during labor and delivery. More than 90% of all epileptic pregnant women give birth to healthy babies.

Medications to Control Seizures. If you take medication for seizure control or prevention, tell your healthcare provider before trying to get pregnant or at the beginning of pregnancy. Medication can be taken during pregnancy to control seizures, but some are safer than others. Ask about taking large doses of folic acid; it has proved helpful in some women.

If you have morning sickness, tell your healthcare provider about it. Nausea and vomiting can interfere with your body’s ability to absorb your medications.

There are concerns regarding use of anticonvulsant medications in pregnancy. There is also concern regarding polytherapy—when a woman takes several medications in combination. Ask your healthcare provider to put you on the lowest dosage of one antiepileptic drug. Take your antiseizure medication exactly as it is prescribed.

Most studies show increased risk to the baby when a mom-to-be takes valproate, especially in the first trimester. There’s evidence exposure of a baby to this medication increases the risk of autism. Talk to your healthcare provider about this medication before you become pregnant or as soon as you know you’re pregnant. Because half of all pregnancies in the United States are unplanned, most experts recommend using another medication as a first-line drug for women of childbearing age.

Dilantin can cause birth defects in a baby. Other medications may be used during pregnancy for seizure prevention. One of the more common is phenobarbital, but there’s some concern about the safety of this medicine. Lamotrigine therapy alone shows no increased risk of problems in baby.

During pregnancy, kidneys may remove greater amounts of antiepileptic drugs from your system more quickly than usual. Drug levels could decrease by as much as 50%. It’s important to see your neurologist every month for blood tests to check the levels in your blood. Any dosage adjustments can be made after test results are in.

Seizures during pregnancy can be serious; you may need increased monitoring during pregnancy. If you have questions or concerns about a history of possible seizures, talk to your healthcare provider about them.

5. Exercise for Week 26

Sit on the floor with your knees bent and your feet flat on the ground. Keep your knees about 12 inches apart. Reach underneath each thigh with your hands, then stretch back slowly until your arms are straight. Keep your feet on the floor as you return to the starting position. Repeat 8 times. Strengthens abdominal muscles, inner thighs and pelvic floor.

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