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| treatment of migraine during pregnancy |
Migraine may be the common disease that affects people around the world. People with migraine experience headache (from mild, moderate, and severe), nausea, vomiting, and sometimes photophobia (hypersensitivity with light). The causes of migraine is definitely uncertain. The role of hormones makes migraine more frequently happen in women, especially between ages 20-45. According to National Center for Biotechnology Information, a beneficial effect of migraine during pregnancy, mainly in the last 2 trimesters, has been observed in 55 to 90% of women who are pregnant, irrespective of their migraine type. In fact, there is a higher percentage of women with menstrual migraine find that their condition becomes worse when they are pregnant. Migraine during pregnancy however may appear only in the first time of pregnancy. The effect of migraine during pregnancy which becomes worse after birth delivery is because the high and stable estrogen levels during pregnancy and the rapid fall off after pregnancy.
Treatment of migraine during pregnancy
- Non pharmacological therapy. It is better for you to try such as: relaxation, smooth massage, aromatherapy, sleep, ice packs, before you start taking drugs that probably have more side effects to the fetus.
- Pharmacological treatment of migraine during pregnancy
- Acetaminophen (paracetamol) 1000 mg used as rectal suppository is highly recommended for acute migraine.
- Ibuprofen and aspirin are second line drugs. They are avoided to take in the third trimester.
- Triptans (sumatriptan, naratriptan, zolmitriptan) are probably safe but we have lack of data that support them. Please review the last part below.
- Metoclopramide is recommended to treat disturbed nausea, and safe to use in the second and third trimester.
- Ergotamine tartrate is contraindicated for pregnant women.
- Betablockers (propanolol, metoprolol) can be used as prophylactic drugs but they are less indicated for pregnant women.
Correlation of NSAIDs drugs during pregnancy and the risk of spontaneous abortion
All types of non aspirin NSAIDs are proven to increase the risk of spontaneous abortion. Please avoid using NSAIDs to treat migraine while you are pregnant or actively trying to get pregnant. The better choice to treat migraine and headache during pregnancy is acetaminophen.
Correlation of Triptan during pregnancy and the risk of adverse pregnancy outcomes and major congenital disorders
Based on FDA, triptans includes in Category C during pregnancy and there are no increased risk shown in fetal abnormalities. The use of triptans during the first trimester is NOT proven to increase the risk of congenital malformation, but triptans that are used in the last trimester of pregnancy was found to be associated with a mild increase of bleeding during labor and atonic uterus.
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