February 07, 2023
The expertise of getting migraines might be brutal and lots of pregnant girls battle with out therapy due to the dangers some medicines pose to their being pregnant. To higher perceive how migraine is – and might be – handled throughout being pregnant, a gaggle of researchers with the Hartford HealthCare Ayer Neuroscience Institute Headache Middle explored present practices to chart a course for future care. The outcomes had been printed in Headache: The Journal of Head and Face Ache. “Migraine therapy throughout being pregnant might be difficult for a lot of causes. We all know some girls obtain all points of care – together with main care, obstetrical/gynecological and migraine care – from their girls’s healthcare supplier, however we all know little or no about how these suppliers method migraine therapy throughout being pregnant,” notes Allison Verhaak, PhD, a scientific well being psychologist with the Headache Middle and a part of a analysis crew that included Headache Middle Director Brian Grosberg, MD.
Migraines in being pregnant
Migraines are commonest throughout girls’s reproductive years, affecting about 25% of these ages 30 to 39. Of those that are affected by migraine, 80% will proceed to have them in some unspecified time in the future throughout their being pregnant, Dr. Verhaak says. “Whereas many ladies report enhancements in migraine throughout being pregnant, notably by the second trimester, as much as 60% might not see enchancment so therapy throughout this time is essential,” she explains.
The Hartford HealthCare analysis crew despatched an internet survey to greater than 400 girls’s healthcare suppliers throughout the state, receiving about 100 responses. Most responses got here from suppliers working towards obstetrics and gynecology. They fielded questions on what, if any, acute and preventive migraine therapies they prescribe to pregnant sufferers. Some outcomes embody:
- 26% reported counseling girls on migraine therapy in being pregnant as early as earlier than conception
- 35% of recommended sufferers after they develop into pregnant
- 63% felt snug recommending or persevering with some acute therapies for a affected person’s migraine, though they had been much less snug with therapies equivalent to triptans
- 40% felt much less snug recommending preventive migraine therapies throughout being pregnant
- 70% had been snug with non-medication approaches to addressing migraine
- 40% report referring pregnant sufferers to neurologists or headache specialists for migraine care
“Our girls’s healthcare suppliers reported feeling very uncomfortable prescribing or recommending the usage of nerve block injections or neuromodulation units for migraine therapy throughout being pregnant,” Dr. Verhaak says, noting that one other research confirmed that headache specialists had been snug with these therapies. As well as, she says the usage of triptans throughout being pregnant has been debated, with the American School of Obstetrics and Gynecology lately addressing the problem in new headache therapy pointers, advising “cautious use” for persistent complications in being pregnant. “This highlights the complexity of migraine therapy throughout being pregnant, together with differing ranges of consolation throughout specialties and challenges of counting on security information that present no hostile results in being pregnant,” she says.
The survey outcomes, she continues, spotlight the totally different consolation ranges between medical specialists who could also be treating pregnant girls with migraine and spotlight the significance of consulting and collaborating on care or offering cross-specialty schooling on migraine therapy pointers. “We hope to assist bridge the information, consolation and therapy gaps between totally different medical specialties who might take care of sufferers with migraine throughout being pregnant. The last word objective is to extend cross-disciplinary conversations and standardized take care of this essential affected person inhabitants,” Dr. Verhaak says. Along with Drs. Verhaak and Grosberg, co-authors of the research included maternal fetal drugs specialist Stephanie Bakaysa, MD obstetrician/gynecologist Amy Johnson, MD Maria Veronesi, MA and Anne Williamson, PhD.