Managing Migraine During Pregnancy and Lactation

Area of Science:

• Neurology
• Obstetrics
• Pharmacology

Background:

• Migraine affects over half of pregnant women, with some experiencing improvement.
• Pregnancy elevates risks for dangerous secondary headaches, particularly hypertensive disorders.
• Previous migraine history may correlate with adverse pregnancy outcomes.

Purpose of the Study:

• To review safe non-pharmacological and pharmacological migraine treatments during pregnancy.
• To highlight emergent secondary headache red flags in pregnant patients.
• To discuss migraine management during the postpartum and breastfeeding period.

Main Methods:

• Literature review of current guidelines and studies on migraine treatment in pregnancy.
• Analysis of safety profiles for common migraine medications and supplements.
• Identification of diagnostic criteria and management strategies for pregnancy-related headaches.

Main Results:

• Non-pharmacological approaches are recommended as initial migraine management in pregnancy.
• Emerging data raises concerns about the safety of certain medications (magnesium, acetaminophen, ondansetron, butalbital) during pregnancy.
• Optimal migraine treatment strategies during lactation require further investigation.

Conclusions:

• Careful consideration of treatment safety is crucial for pregnant individuals with migraine.
• Prompt recognition and management of secondary headaches are vital.
• Further research is needed to clarify the safety and efficacy of migraine treatments during breastfeeding.