Headache in pregnancy: a brief practical guide

Phillips, Katherine W.; Davison, Jessica M.; Wakerley, Benjamin R

doi:10.3399/bjgp22x721457

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…Overlap was quantified using corrected covered area (CCA). Overlap was rated as slight (0-5), moderate (6)(7)(8)(9)(10), high (11)(12)(13)(14)(15) and very high (>15) (18). In the case of high or very high overlap, one review was selected for inclusion.…”

Section: Overlapping Reviewsmentioning

confidence: 99%

“…Recommended treatment options during pregnancy include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) (prior to the third trimester) or triptans for symptom relief and aspirin, beta blockers and amitriptyline for migraine prophylaxis (9). However, even for these medications, there is a paucity of evidence regarding their safety in pregnancy, meaning that it is advised they are used with caution (10,11). Despite this, medication use and polypharmacy are prevalent in pregnant women with migraine.…”

Section: Introductionmentioning

confidence: 99%

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How migraine and its associated treatment impact on pregnancy outcomes: Umbrella review with updated systematic review and meta-analysis

Phillips,

Clerkin-Oliver,

Nirantharakumar

et al. 2024

Cephalalgia

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Background Migraine is common in reproductive aged women. Understanding the impact of migraine and associated treatments on pregnancy outcomes remains very important. An umbrella review of systematic reviews, with or without meta-analyses, examined the link between migraine and pregnancy outcomes. Methods We systematically searched Medline, Embase and Cochrane to 27 October 2022. Quality appraisal was carried out using the AMSTAR2 tool. An established framework was used to determine whether included reviews were eligible for update. Results Four studies met review criteria. Migraine was reported to be associated with increased odds ratio (OR) of pre-eclampsia, low birth weight and peripartum mental illness (pooled OR = 3.54 (2.24–5.59)). Triptan-exposed women had increased odds of miscarriage compared to women without migraine (pooled OR = 3.54 (2.24–5.59)). In updated meta-analyses, migraine was associated with an increased odds of pre-eclampsia and preterm birth (pooled OR = 2.05 (1.47–2.84) and 1.26 (1.21–1.32) respectively). Conclusions Migraine is associated with increased odds of pre-eclampsia, peripartum mental illness and preterm birth. Further investigation of the relationship between migraine and placental abruption, low birth weight and small for gestational age is warranted, as well as the relationship between migraine, triptans and miscarriage risk. Systematic Review Registration: Prospero CRD42022357630

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Section: Overlapping Reviewsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How migraine and its associated treatment impact on pregnancy outcomes: Umbrella review with updated systematic review and meta-analysis

Phillips,

Clerkin-Oliver,

Nirantharakumar

et al. 2024

Cephalalgia

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“…Taking a Cold Shower/ Splash Cool Water on Face: It works by constricting the dilated blood vessels in the head to bring fast, relief other alternative Indian system treatments-green colour therapy, Yoga, Pranayama & Taking a break (small nap) to address fatigue and exhaustion [17].…”

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confidence: 99%

"Primary Headaches of Patients - A Challenge for Primary Care Physicians"

Kishanrao¹

2023

BJSTR

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Headaches, medially known as cephalalgia, is one of the most common disorders of the nervous system. Approximately half of all adults have had a headache during the past year, and it is the sixth cause of disability in the world. It is the most disabling conditions and can have a substantial impact on quality of life of those affected. If it occurs repeatedly, it may be called as headache disorder. The latest International Classification of Headache Disorders has broadly classified headache disorders into primary and secondary based on their origin. Primary headache the subject of this paper is triggered by lifestyle factors, like alcohol, particularly red wine, processed meats that contain nitrates, changes in sleep or lack of sleep, poor posture, skipped meals & stress. Majority of those with headache have primary headache disorder especially migraine, tension-type headache, and medication-overuse headache. The tension-type headache (TTH), episodic TTH of less than 15 days/month, is reported by more than 70% in some populations. Stress is one of the main aggravating factors across geographies, more so in millennials and females. The Global Burden of Disease Study 2019 estimated that migraine caused 41.1 million YLDs 5.4% of Total YLDs, and tensiontype headache 5.5 million years of life lived with disability. Headache disorders are most troublesome in the productive years of life with lost working days and reduced productivity. Without proper treatment, can become chronic or recurring affecting the well-being of an individual and predispose them to other illnesses.Self-care with simple analgesics in managing primary headache disorders can help reduce frequency of attack and severity with positive effect on physical symptoms and functional capacity. Paracetamol (acetaminophen) is a safe analgesic with good gastrointestinal tolerance and is first line option. Caffeine's anti-nociception enhancing effect when given with acetaminophen significantly improves efficacy over use of paracetamol alone. Ninety percent of headaches seen in practice are due to a primary headache disorder where there are no confirmatory tests, and neuroimaging studies, if done, are normal. In this review use of a logarithm is suggested that makes first an emphasis on the recognition of red flags that help in the identification of secondary headaches, referral or management and expects establishing good referral mechanisms in the health system. This also emphasises most importantly a good history taking that allows the physician to recognize a pattern that in turn leads to the correct diagnosis for better management. A comprehensive history needs time, interest, focus and establishment of rapport with the patient. When to ask what question to elicit which information, is an art that is acquired by practice and improves with experience. Methods & Materials:This review is based on eight case studies of various types of headaches, and literature review and a logarithm suggested by

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Headache in pregnancy: a brief practical guide

Cited by 2 publications

References 5 publications

How migraine and its associated treatment impact on pregnancy outcomes: Umbrella review with updated systematic review and meta-analysis

How migraine and its associated treatment impact on pregnancy outcomes: Umbrella review with updated systematic review and meta-analysis

"Primary Headaches of Patients - A Challenge for Primary Care Physicians"

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