A University of New Mexico neurologist has recently started a monthly clinic specializing in care for women with epilepsy during pregnancy so they can deliver healthy babies.
Epilepsy is a neurological disorder which can occur at any age. It is characterized by unpredictable seizures that can cause convulsions or loss of awareness. Roughly three to five out of every 1,000 births in the U.S. are to women who have epilepsy, according to Annapoorna Bhat, a doctor who launched the clinic during the summer.
Bhat, an assistant professor in the UNM Department of Neurology, said women with epilepsy are considered at high risk for obstetrical complications. A grand mal seizure, which causes loss of consciousness and violent muscle contractions, can compromise blood flow to the fetus. Milder seizures which result in a momentary lapse in awareness can leave a person confused for several minutes, leading to a risk in falls.
“That’s the reason we want to control seizures during pregnancy,” Bhat said.
She saw the need for the clinic after noticing that women with the seizure disorder often had to wait several months to see an epilepsy specialist, often putting them past their delivery due date.
She said it is important to ensure that the patient is on the right medication and taking the correct dosage to manage their symptoms during pregnancy. Bhat and her staff at the clinic at the Neuroscience Center at UNM Hospital see patients monthly. She said it’s important to monitor medication and adjust the dosage as the mother-to-be’s body changes while her pregnancy progresses.
Bhat encourages women with epilepsy to work with their medical providers to get on the right medication before they become pregnant.
“Studies show that if they did well on a particular medication before they got pregnant, they will continue to do well after they become pregnant,” Bhat said. However, she said, many pregnancies are unplanned and staff at her clinic will work to optimize medication and adjust dosages as needed.
Once the mother has delivered her baby, she comes for a post-partum visit at the clinic to re-adjust the medication and check if breast feeding is going well. After that that they can go to a regular clinic.
Bhat said the clinic accepts Medicaid and private health insurance and is open to women from anywhere in New Mexico. Patients must be referred by their medical provider. The clinic can be reached by calling 505-272-3160. Referrals must be faxed to 505-272-9427. Bhat recommends sending records of any blood work and brain imaging.
Presbyterian Healthcare Services also offers specialized care for expectant women with epilepsy.
Dr. Tushar Dandade, medical director for the women’s program at Presbyterian, said Presbyterian takes a multidisciplinary approach involving obstetricians, neurologists and neonatologists in planning the care and treatment of women with seizure disorders.
He said the Presbyterian team typically works with the patient’s personal provider in the ongoing care during pregnancy.
Patients who are on anti-seizure medications are screened to ensure they are on medications with the least side effects for mother and baby, he said.