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Migraines & Headaches Health Center

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Migraine Headaches and Pregnancy

Tests for Migraines

Headaches can be caused by a pregnancy complication called preeclampsia. So your doctor may evaluate you for that condition before making a diagnosis of migraine. Be sure to tell your doctor about all the medications you're taking, including over-the-counter products and natural supplements. Also let your doctor know whether anyone in your family has had migraines.

The doctor often can diagnose migraine from a headache diary and your medical history. CT scans and other radiology tests to rule out other causes of your headaches aren't usually advised in pregnancy. That's because of the potential risks to the fetus.

Self-Care of Migraines

Your first line of defense against migraine headaches is a healthy lifestyle and self-care. Here are some tips to help you manage migraines during pregnancy:

  • Avoid your known triggers, such as specific foods, as much as possible.
  • Keep a predictable schedule of meals and snacks.
  • Drink plenty of water.
  • Get plenty of rest.
  • Consider taking a class in biofeedback or other relaxation technique.
  • When pain strikes, try ice packs, massage, and resting in a quiet, darkened room.

Medications for Migraines

If you're pregnant -- or planning to get pregnant soon -- your doctor will generally advise you to stay off medications unless they're absolutely needed. Together, you'll have to weigh the potential effects of a drug on your unborn baby. In some cases, a decision will need to be made based on scant or inconclusive research into a particular drug.

Many of the anti-migraine medications to treat or prevent migraine headache and its symptoms should be avoided during pregnancy. That's because they've been linked to birth defects in babies. Other medications are associated with pregnancy complications. For instance, some have been associated with bleeding, miscarriage, or intrauterine growth restriction (IUGR), a condition in which the uterus and fetus don't grow normally.

Acute Migraine Treatment

Acute treatment aims to stop a migraine attack after its first signs appear.

Pain relievers, also called analgesics, may help ease the intense pain of migraines. These general pain-relieving drugs, though, aren't specific to the migraine pain pathway:

  • Acetaminophen is generally considered low-risk during pregnancy.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, may carry a risk of bleeding and miscarriage if taken near the time of conception. There is also a possible risk of blood pressure complications in the baby if they are taken in the third trimester. Aspirin taken near delivery may lead to excess blood loss in mothers during birth.
  • Most NSAIDs, including ibuprofen -- sold over the counter under the brand names Advil and Motrin -- and naproxen -- sold as Aleve and other brands -- don't have enough controlled human research studies to assess all their risks in pregnancy.
  • Narcotic pain relievers should generally be avoided. There is a dual risk of addiction in both mothers and babies if they are used for prolonged periods of time.

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