What are neural tube defects?

[Spaceboundeminem]

I am trying to decide whether to ttc while remaining on a medication my doctor has told me is not pg safe as it increases the chance of neural tube defects. can someone explain them please? Also does anything else reduce/increase the risks of these?

The neural tube will be what the nervous system develops from. Obviously any problems with its development would potentially be severe. What medication are you on?

Don't risk it.

Go back to your Dr, tell her you want to ttc, and discuss your options for changing or stopping your medication.

The reason your dr has advised not taking them is that these defects happen during the first weeks of development. So by the time you realised you were pregnant it would be too late.

Neural tube defects = spina bifida. Horrible risk, not worth taking.

They mean things like spina bifida. Taking folic acid before pregnancy is the best way of reducing the risk. I agree with pp though, go back and go through alternative options.

Broadly speaking, neural tube defects are birth defects of the brain and spinal cord. In other words your medication could cause or increase the risk of brain damage or spinal cord damage in your unborn baby, damage such as spina bifida or cerebral palsy. I would think very carefully about whether or not you could cope with a severely disabled child or a medical termination before you attempt to ttc on these kinds of meds. Has your doctor mentioned how far your meds increase the risk?

He hasn't mentioned how much it increases the risk by. It is sodium valproate I did ask to switch but he wouldn't (he is a useless Dr who has caused me a lot of harm) I will stop taking it I have that option.

I already have a severely disabled child and while I wouldn't terminate I think I would prefer to keep risk to a minimum.

You really shouldn't risk it. Along with spina bifida there's anacephaly, which is incompatible with life.

Oh I take Sodium Val. It's nasty, nasty stuff. Severely risky to baby. Have you tried quetiapine? While still not safe, it's generally considered to be safer.

I take olanzapine as well as sodium valproate and clonazepam I am pretty sure we are going to drop sodium valproate and clonazepam and stick with olanzapine which is I believe a safer medication during pg.

You could switch out the clonazepam for diazepam which is generally considered safer outside of the final trimester. Olanzapine is the safest anti-psych for use during pregnancy but still risky-but far, far safer than sodium val.

Thank you if I start to become unwell I shall ask to switch to diazepam. I am only really worried about becoming unwell while ttc or post natally as in previous pg I have been completely stable during pg and only ill while ttc and postnattaly.

So hopefully I will follow suit and be stable through this pg but I should be fine anyway as olanzapine has so far been the best medication for me.

Please don't risk it. Diazapam is risky too. I'm assuming you have bipolar disorder from your meds. Ask about quetiapine, that's what I take and research indicates it doesn't cause NTD. Have you been referred to perinatal team? X

Oops, sorry, missed TTC bit.

Why not ask your gp to refer you to a consultant psychiatrist to discuss safer medications?

I won't risk it as I think ill be fine once I am pg. I do have bipolar 1. My doctor hasn't refferred Me at all. He is pretty useless tbh I am trying to change doctors. He refused to change me of arirpiprazole despite be being unwell for a year I had to go over his head to my previous doctor.

I'm sorry to be negative, but you won't be fine when you're pregnant. It's hard to accept, even harder to admit, but pregnancy is hard on any woman and it's worse for women with bipolar 1 (I have it too). It's the most dangerous, riskiest time in a bipolar woman's life as the risk of relapse is INCREDIBLY high, even if you're already stable (which I was). I'm under the perinatal team as I have had a relapse and I recommend them. They can feel intrusive but they're there to help manage that risk and support you. Please don't go into this blind.

Go see a different dr- are you talking about a GP? If it is go see another one in the practice. If not go and see a GP, explain your difficulty and get them to refer you to another hospital/department/dr. You have a right to choose.

Thank you I am talking about my psychiatrist.

Hello,

The best thing to do is probably to ask for a referral to a perinatal psychiatrist. They should be very experienced in these matters. Sodium valproate use in pregnancy has been linked to a number of birth defects in the baby, as well as problems with learning and behvoiur in children who were exposed in the womb. It is not actually known at the moment whether taking folic acid, even at high (5mg/day) reduces the risk of any of these problems (although pregnant women taking valproate should always be advised to take high dose folic acid). Hope this helps and good luck with ecverything

Thanks all I will ask to be refferred.