Childhood migraine

Pregnancy
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By Raymond S Kandt MD

Migraine is sometimes relieved or exacerbated by pregnancy, but migraine does not have a direct adverse effect on pregnancy. However, migraine treatments are potentially harmful (eg, ergotamine may cause uterine contractions). Nondrug treatments such as biofeedback are preferred. Acetaminophen is generally safe for acute attacks. Ondansetron can help decrease the nausea and vomiting, and is safe during pregnancy (Pasternak et al 2013). Noting the potential risks of using medication during pregnancy (eg, teratogenicity), other options for treatment include a 6-day taper of prednisone (following 12 weeks’ gestation), metoclopramide, or prochlorperazine. Fluoxetine has been used as a migraine-preventive agent during pregnancy. However, because adverse pregnancy outcomes have occurred when selective serotonin reuptake inhibitors have been used for the treatment of depression during pregnancy, caution must be exercised when treating migraine.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Pregnancy
Anesthesia
References cited
Contributors