While the majority of pregnant women with acute migraine received medications considered relatively safe in pregnancy, there was variation in treatment choice and sequence, a recent study found. Researchers conducted a retrospective chart review of medication administration for pregnant women who presented to an acute care setting with a migraine attack and received neurology consultation between 2009 and 2014. They identified 72 pregnant women with migraine who were treated with pain medications and found:
- Fifty-one percent (37/72) were in the third trimester of pregnancy, 39% (28/72) in the second trimester, and 10% (7/72) in the first trimester.
- Thirty-two percent (23/72) had not tried any acute medications at home before coming to the hospital, and 47% (34/72) presented in status migrainosus.
- Patients received treatment in the hospital for a median of 23 hours.
- Acetaminophen was the most frequent medicine administered first (53%, 38/72).
- Thirty-eight percent (27/72) received an intravenous (IV) fluid bolus, 24% received IV magnesium (17/72), and 6% (4/72) had peripheral nerve blocks performed.
Hamilton KT, Robbins MS. Migraine treatment in pregnant women presenting to acute care: A retrospective observational study. [Published online ahead of print November 7, 2018]. Headache. doi:10.1111/head.13434.