Epilepsy in pregnancy: postpartum management

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Epilepsy in pregnancy: postpartum management. Then return to preconception dose by 7 days post-partum. Fully referenced neurology checklist.

Post-partum anti-epileptic drug management

  • Reduce increased antiepileptic dose by 50% within the first 3 days post-partum
  • Then return to preconception dose by 7 days post-partum
  • Encourage breastfeeding on AEDs

Precautions on handling the baby

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Post-partum monitoring indices

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Post-partum management if the mother is on an enzyme-inducing AED

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References

  1. Nucera B, Brigo F, Trinka E, Kalss G. Treatment and care of women with epilepsy before, during, and after pregnancy: a practical guide. Ther Adv Neurol Disord 2022; 15:17562864221101687. 
  2. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. NICE Clinical Guideline [CG137]. January 2012.
  3. Duncan S, Fairey A, Gomersall S, et al. Primary care guidelines for the management of females with epilepsy. Royal Society of Medicine Press Ltd London 2004.
  4. Harden CL, Pennell PB, Koppel BS et al. Practice parameter update: management issues for women with epilepsy-focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009; 73:142-149.Management of epilepsy in women
  5. Sawle GV, Ramsay MM. The neurology of pregnancy. JNNP 1998; 64:711-725.

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