Purpose Of Review: While most women with migraine improve during pregnancy, a subset may remain unchanged or even become more severe. Given the limited evidence for the use of prescription medications during pregnancy, many look to other treatment modalities. We seek to review complementary and integrative medicine, procedural interventions, and neurostimulation to empower women with safe and effective treatment options during pregnancy.
Recent Findings: Migraine treatment during pregnancy remains controversial. While evidence is limited, prospective and retrospective reviews, as well as clinical experience support the use of nutraceuticals, procedural interventions, and neurostimulation during pregnancy when the appropriate risks and benefits are weighed. Empowering patients with information on complementary and integrative medicine, as well as non-systemic and interventional treatments, may help to reduce anxiety and headache burden during pregnancy. Various nutraceuticals have shown promise for the preventive management of migraine. Non-systemic interventions such as trigger point injections and peripheral and sphenopalatine nerve blocks offer effective treatment options with minimal side-effects. Options for neurostimulation have expanded in recent years and may offer safe and effective non-pharmacologic options for the management of migraine. It is imperative that providers do not minimize migraine during pregnancy and become aware of the treatment modalities available to help guide women through this experience.
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Article Synopsis
- Idiopathic intracranial hypertension (IIH) primarily affects overweight or obese women of reproductive age, making it crucial to investigate its relationship with pregnancy.
- A study examined the incidence of IIH development during pregnancy and its association with hypertensive disorders, finding that 7% of IIH patients experienced new onset IIH during their pregnancies.
- IIH patients had significantly higher risks for various hypertensive disorders like eclampsia, preeclampsia, and HELLP syndrome, as well as complications like ectopic pregnancies and miscarriages, even when controlling for obesity and migraine factors.
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