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The choice and
sequence of treatment varies in majority of pregnant women with acute migraine,
so it is essential to standardize practices for the acute treatment of
migraine in pregnancy.
In the report of an analysis conducted by the investigators of the Montefiore Headache Center, Albert Einstein College of Medicine, New York, the need for specific protocols and guidelines appeared for the management of migraine during pregnancy. One of the common problems arise among pregnant women is the migraine, and it is difficult to treat this issue due to fears of medication teratogenicity and lack of evidence in this population. This study attempted to collect the information by conducting a retrospective chart review of medication among pregnant females who introduced to an acute care context with a migraine attack and obtained neurology consultation from 2009 to 2014.
A total of 72 pregnant females with migraine who took the medications for an average of 23 hours to alleviate pain were selected for the analysis. Out of 72 women with migraine, 37 were in the third, 28 in the second and 7 in the first trimester. Metoclopramide and Acetaminophen were the most commonly prescribed medicines. Acetaminophen used as the first line treatments in among at least 53% of patients. Many of the patients who received Metoclopramide, took the medication along with Diphenhydramine. Twenty-nine per cent of patients received Butalbital or Opioids, Twenty-four received IV magnesium, thirty-eight obtained an intravenous (IV) fluid bolus, and six per cent went through peripheral nerve blocks.
There are the
majority of medicines present to treat migraine among pregnant women, but the
treatment choice and sequence varies. Some of the treatments such as Butalbital
and Opioids are unsafe for fetal used frequently, whereas the treatments like
IV fluid boluses, nerve blocks, or triptans with low teratogenic risk were not
at all used or used less. All these issues can be managed by developing
specific guidelines.
Headache
Migraine Treatment in Pregnant Women Presenting to Acute Care: A Retrospective Observational Study.
Katherine T. Hamilton, Matthew S. Robbins
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