Navigating migraine care during pregnancy and lactation

Area of Science:

• Neurology
• Obstetrics
• Pharmacology

Background:

• Migraine management during pregnancy, postpartum, and lactation presents unique challenges.
• Traditional approaches often involve medication avoidance, potentially compromising maternal well-being.
• Recent evidence and guidelines necessitate a more nuanced, evidence-based approach.

Purpose of the Study:

• To review current evidence on migraine management during pregnancy and lactation.
• To provide guideline-based recommendations for acute and preventive migraine treatment.
• To address the safety of migraine-specific therapies during lactation and preconception medication discontinuation.

Main Methods:

• Comprehensive literature review of recent evidence.
• Analysis of guidelines from the American College of Obstetricians and Gynecologists.
• Development of a collaborative, individualized care framework.

Main Results:

• Migraine management requires individualized decision-making, integrating pharmacologic and procedural strategies.
• A collaborative framework balances maternal function preservation with fetal and neonatal risk minimization.
• Low-exposure procedural interventions can reduce migraine disability.

Conclusions:

• Effective migraine care during pregnancy is achievable and essential.
• Structured preconception planning and safe therapy selection are crucial.
• Coordinated neurologic-obstetric care supports maternal health and improves outcomes.