Is migraine during pregnancy common or serious? Migraine and pregnancy. Causes and treatment

Often, severe attacks of headaches appear in those women who have not encountered them before. But this becomes a real problem, because pregnant women should not take medicines that are allowed to other patients. Statistics show that about a quarter of all women who are preparing to become a mother begin to suffer from migraine attacks. If migraine develops during pregnancy, what to do and how to treat, you need to ask your gynecologist.

It's not hard to imagine how pain disturb the body, already experiencing a critical period of life. If migraine is pronounced and cannot be tolerated, then effective medicines should be used. Otherwise, the attacks will have a negative impact on both the pregnant woman and the development of her fetus.

Migraine attacks usually occur due to hereditary factors, passed from mother to daughter. They are manifested by severe throbbing headaches, extending to only one half of the skull. Conventional painkillers and vasodilators, such as paracetamol or No-Shpa, are not always able to stop the symptoms of attacks.

Migraine during pregnancy early dates and later accompanied by an aura. That is, in a woman, before the development of paroxysmal pain, precursors appear:

Fear of harsh light;
High sensitivity to strong sounds and noises;
Intolerance to certain odors;
Nausea, vomiting;
Psycho-emotional disorders, which can be manifested by isolation, irritability, apathy.

A migraine attack in pregnant women is often perceived as the result of a weakened body. But this is not a simple malaise or overwork. Here you can not do with the reception of Citramon or a cold compress applied to the temples. The treatment of a migraine attack should be prescribed by a professional, because on recent months before childbirth, it will not be possible to use anti-migraine tablets.

What can trigger migraine in pregnancy? There are many such factors:

Food (chocolate, cheese, nuts, citrus fruits, etc.), alcohol, hot spices;
Dehydration of the body;
Overdose of medicines, including Citramon;
stressful situations;
Sleep deprivation, malnutrition;
allergic reactions;
Meteorological dependence, etc.

A migraine attack usually occurs after irritation of the body by one of the listed provocateurs. Therefore, a woman must analyze what exactly causes headache. If you change your lifestyle and exclude contact with an irritant, then you can prevent the next development of a migraine attack.

It is important to know that pregnant women are strictly forbidden to take any medication without consulting a doctor. Even simple medicines with safe active ingredients can be a threat to the development of a child. Often, self-medication leads to the formation of intrauterine anomalies that are incompatible with the life of the baby. It is especially necessary to follow the treatment in the early stages of pregnancy, when the fetus is just beginning to develop. In the second trimester, pills can disrupt the functionality of the child's body systems or provoke premature birth.

Only a gynecologist will help eliminate the disease and stop severe symptoms. First of all, the doctor recommends a pregnant woman when the first pain lie down and have a good rest. Often such simple advice helps to relieve a migraine attack of a mild course. You can also additionally drink a soothing decoction of lemon balm, mint, chamomile, valerian. The dosage of herbal medicines should be selected by a gynecologist.

If a migraine attack starts due to malnutrition or hunger, then it is better to immediately drink hot tea with a lot of sugar or eat candy. Glucose also improves the condition and relieves headaches. Thus, pregnant women can prevent a migraine attack without using medicines.

For pain moderate It is recommended to take No-Shpy pill. It quickly relieves spasm of cerebral vessels, relaxes muscle tissue, which reduces pressure and pain disappears. It is also good to drink children's Paracetamol, which is safe for pregnant women and the fetus. With a decrease in pressure, it is better to take Panadol Extra with caffeine, which will improve blood flow. It is strictly forbidden to use Aspirin or Analgin.

When to see a doctor urgently:

Migraine attacks torment almost constantly and the pain intensifies;
Pain appears in the morning after a night's rest;
The pain extends to only one part of the head;
Migraine is accompanied by impaired speech, hearing, motor functions, etc.;
Migraine attack appears due to reduced or high blood pressure.

What drugs can a doctor prescribe for pregnant women suffering from headache attacks? As already mentioned, many drugs from the pharmacy are strictly forbidden to be taken during pregnancy, especially in the first trimester. But there are also safe medications that relieve a migraine attack and make its treatment suitable for most women.

So, illicit drugs include painkillers such as Analgin and Aspirin. The first medicine in initial stage fetal development can provoke a violation of the formation of the baby's organs. It is well known that Aspirin and its derivatives cause malformations of the heart and lower jaw of the fetus. And in the third trimester, Citramon, Askofen, Citrapar and other aspirin-containing drugs can provoke bleeding during childbirth and premature blockage of the arterial duct in a child.

Analgin is a toxic substance that, even in small doses, can change the composition of the blood of a pregnant woman. Its derivatives - Baralgin, Spazmalgon and others have the same negative impacts. Long-term use of analgesics is especially dangerous.

Now let's look at pills that are safe for the mother and the unborn child. But even they are prescribed only from the second trimester and their intake should be monitored by a doctor:

No-Shpa - taken with an increase in head pain;
Children's Paracetamol - relieves painful symptoms;
Actovigin - is prescribed if a woman has problems with blood circulation;
Adult Citramon - only half a tablet after 12 weeks of pregnancy;
Ointment Asterisk - applied to the temples and bandaged the head with a woolen scarf or scarf;
Panadol, Efferalgan - only suitable for cupping severe pain, caffeine-containing drugs are used in the treatment of migraine caused by a decrease in pressure;
Antihypertensive drugs - prescribed for high blood pressure, add complex therapy;
Antimigraine drugs - rarely used during pregnancy, but with an adequate selection of dosage, they relieve a migraine attack well.

At home, folk remedies help relieve migraine attacks. Many women are afraid to go to doctors to ask if certain recommendations from alternative medicine can be used. But there is nothing to worry about and, usually, gynecologists and other specialists during pregnancy advise just simple folk remedies.

Each woman can take note of a few simple recipes for headaches:

If not diabetes, then ordinary, well-sweetened tea is very good and quickly stops a migraine attack. It can be any pleasant, but strongly brewed drink. It should be drunk immediately as soon as a woman feels an increase in headache.
A raw cabbage leaf can overcome a migraine attack. To do this, you need to cut it a little or ceiling it with a wooden spoon to let the juice flow. Therefore, the sheet is applied to the sore side of the head and tied very tightly with a handkerchief.
You can make compresses from ice cubes, but do not keep it for a long time so as not to catch a cold.
Some patients rub their temples with lavender water. This medicinal plant relaxes muscle tissue, soothes and relieves pain. It is also useful to breathe in the aroma of citrus fruits, as they have an invigorating effect. It is better to use essential oils if there is no allergic reaction.

Even pregnant women are advised to pour their feet every morning cold water from under the shower. The temperature should not be below 22 0 C, so as not to catch a cold. If you stand under some water for 5 minutes, then this procedure will be a good prophylactic against migraine attacks and varicose veins. Cold has a positive effect on blood vessels, improves their tone and prevents the development of throbbing pain during a migraine attack.

chief preventive measure is proper nutrition, good vacation and adequate sleep. If you adhere to these conditions, then during pregnancy you can avoid the occurrence of migraine attacks. In addition, even at the planning stage, a woman should be examined so that the conception of a child is carried out in a healthy body.

But since pregnant women cannot protect themselves from headaches, since the main reason for their development is a change hormonal background and functions of the genital organs, it is important to prepare in advance for the onset of a migraine. As soon as migraine attacks come, do not panic or seek recommendations from friends. Immediately you need to see a gynecologist who will prescribe effective treatment safe for the fetus. And after giving birth, these symptoms will go away on their own.

Many migraine sufferers are afraid to plan a pregnancy. These fears are justified - judging by the instructions, 99% of drugs should not be taken in position. However, a review of studies on migraine during pregnancy found that there are treatment options.

Good news: up to 80% of women experience relief of attacks already in the first trimester (especially among the group with menstrual migraines), up to 60% forget about it until the end of breastfeeding. For 4-8% of expectant mothers, a miracle does not happen, it was for them that I conducted my research.

Information on sources and literature is placed at the end of the article with a detailed commentary.

Does migraine affect pregnancy

Potential problems are possible, and you need to know about them in advance. But, if we are attentive to ourselves and collect a small amount of knowledge, it will be easier to survive this period.

Severe attacks with aura that last longer than a day and continue into the second and third trimester can cause anxiety. Such conditions can provoke preeclampsia and some other complications (in the article I do not want to write any frightening statistics, but I must indicate the source for self-study).

Migraine does not directly affect the fetus. However, the child is indirectly harmed by the poor health of the mother, lack of sleep and starvation during severe attacks. Low weight the baby is the most frequent negative impact of the disease. Therefore, in severe cases, you need to try to stop the attack, and not try to endure it.

What symptoms should alert the expectant mother

Some migraine symptoms, especially those that appear for the first time, may be a reason to see a doctor (urgently):

You have experienced an aura for the first time or it lasts longer than an hour;
High blood pressure (measure always, even when you assume that a typical attack has come);
The pain came on suddenly and reached its maximum intensity in 1 minute;
The temperature has risen, the neck muscles are in spasm (it is necessary to call the joint venture);
Simultaneous light and sound phobia;
The headache is not one-sided, but just as strong and throbbing;
Change in the nature of pain;
The first attack comes at the end of the second or third trimester.

The doctor will carefully evaluate atypical manifestations and exclude other diseases, may prescribe an additional examination.

How to relieve a migraine attack in pregnancy

For ethical reasons, pregnant women are not allowed to participate in any controlled drug trials. Therefore, in the instructions for the vast majority of drugs, pregnancy is a contraindication to taking - we cannot directly prove safety. But this does not mean at all that "everything is impossible."

Tablets adapted from Nature Reviews Neurology 11, 209–219 (2015). The original and translation are in the appendix at the end of the article.

We have access to therapeutic and clinical observations that are entered into special registers in all developed countries. Based on the results of systematic reviews of data from such registries, clinicians draw conclusions about the degree of safety of medicines.

This article is the result of a study of several dozen recent reviews.

I'll start with heavy artillery. A cautious attitude is still preserved towards serotonin 5-HT1 agonists - triptans. However, application experience is accumulating and more and more encouraging data are emerging.

Triptans

This is a relatively young class of drugs, but all migraine sufferers are familiar with them, as this is the “gold standard” of treatment. The most studied is sumatriptan, approved for use in 1995 - clinical history substances for 20 years.

Of the eight currently used triptans, it has the least pronounced vasoconstrictive effect and does not cause uterine contractions. Sumatriptan can be considered a conditionally safe therapeutic alternative for pregnant women experiencing worsening migraine in the first trimester.

More and more clinical data, and they do not show negative influence sumatriptan on the course of pregnancy and the health of the child. However, for women with a history of migraine, there is always a statistically significant number of newborns weighing less than 2500 g (both those who took the drug and not).

Literally before the publication of the article, I found the latest British medical manual, in which there is sumatriptan in the recommendations with an addition: “no adverse outcomes have been identified, it can be recommended.”

Not so long ago, studies began on the living placenta: no more than 15% of a single minimum dose overcomes the barrier. This amount of substance does not have any effect on the fetus. Prenatal use should be discontinued as the substance may increase the risk of postpartum haemorrhage. This is directly related to its mechanism of action.

The largest studies of AC5-HT1 are carried out by Norwegians, Swedes and Danes. They have phenomenal medical registries that document everything. I recommend that you read the Norwegian review, as it contains a number of valuable information that cannot be fit into the article.

Non-steroidal anti-inflammatory drugs (NSAIDs)

ibuprofen, naproxen And diclofenac considered a relatively safe choice in the second trimester, but not recommended in I and III. Ibuprofen should be avoided after 30 weeks due to an increased risk of premature closure of the ductus arteriosus and oligohydramnios. Some population-based studies support problems from NSAIDs in the first trimester, others do not.

The conclusion of a meta-review of all studies on ibuprofen for migraine is that it is 45% more effective than placebo on average.

Taking NSAIDs interferes with conception and seriously increases the risk of miscarriage.

Aspirin in minimal doses, it can be taken until the third trimester, no later than 30 weeks (no more than 75 mg per day), if it led to migraine relief before pregnancy. If aspirin did not help, there is no point in taking risks, as it affects the function of the baby's platelets.

Analgesics

Paracetamol(acetaminophen) is the drug of choice for pain relief during an attack. Most effective in combination with aspirin and caffeine (our Citramon or Citrapak). Caffeine in this case acts as a transport, helps the absorption of substances and its amount in a tablet does not have any stimulating effect. It is necessary to remember about the restrictions on the intake of acetylsalicylic acid.

The Journal of Headache and Pain (2017) 18:106 page 11 states: “Based on the above data, paracetamol 500 mg or in combination with aspirin 100 mg, metoclopramide 10 mg, or tramadol 50 mg is recommended as the first choice for symptomatic treatment of severe attacks."

Some women stop the attack with paracetamol if they manage to take it in the first minutes after the “turning on” of the aura.

Acetaminophen or paracetamol

A large Danish study showed a statistically significant increase in hyperactivity in babies whose mothers took at least 2 doses of paracetamol per week during pregnancy. Other reviews find no such correlations. Of course, dosage and frequency of administration are crucial.

Caffeine

There are lucky women who can significantly reduce migraine pain with a cup of coffee. Sometimes this trick is obtained even by me. Coffee is the easiest and safest way to help yourself during an attack. There is no evidence of a negative effect of household doses of caffeine on the course of pregnancy and the fetus (2 cups per day). If caffeine helped earlier, you should not give it up in position.

Opiates and opioids

Only the weak like tramadol And codeine. One or two admissions are allowed for the entire prenatal period if none of the above work. Plant-derived opioids are uncommon, but sage tea should be avoided (besides the opiate content, it is believed to cause uterine contractions).

Even if tramadol relieved pain well before pregnancy, try other options. Most likely, during this period, opiates will increase nausea and there will be no point in taking them at all. Although I do understand migraineurs very well, holding on tight to what first helped. The main problem is chronic pain, which is quickly fixed on the background of taking opiates. Over time, there will be nothing to stop the attacks.

Antiemetics

metoclopramide And cyclizine sometimes prescribed for severe toxicosis, and no less effective domperidone has not yet been sufficiently studied. An antiemetic greatly relieves migraine symptoms and increases the likelihood of the drug working directly (it is recommended to take it together with sumatriptan).

metoclopramide

Chlorpromazine and prochlorperazine strictly until the third trimester. Doxylamine, histamine H1 receptor antagonists, pyridoxine, dicyclomine and phenothiazines were not observed in adverse influences on the fetus and pregnancy, but they are prescribed much less frequently than metoclopramide. The problem with antiemetics is side effects, avoid systematic use.

The group of preventive measures includes medicines, dietary supplements (BAA) and something from physiotherapy: massage and acupuncture. I won’t swear about acupuncture here, moreover, as part of placebo psychotherapy, it helps with pain and anxiety disorders (Acupuncture for the prevention of episodic migraine). I looked through several British manuals - not a word about acupuncture, it’s already nice.

Medicines

Almost everything that is usually recommended for migraine prevention is not suitable for expectant mothers: beta-blockers, antiepileptics, antidepressants, ACE inhibitors, ARBs, calcium channel blockers, and the little-studied botulinum toxin type A (BTX-A).

All this is used to treat hypertension, depression and epilepsy. We do not prescribe such drugs to ourselves, therefore, when planning a pregnancy, you need to ask the doctor questions about reducing doses or the possibility of temporarily canceling some drugs from these groups.

Beta blockers

Things are tricky with antihypertensive drugs like metoprolol and propranolol. Most of the evidence converges to the fact that you need to gradually stop taking them even before conception.

Propranolol has a strong evidence base for the prevention of migraine and in some cases it is necessary in hypertensive patients, including in position. Then his reception continues at the lowest possible dose strictly until the second trimester.

Lisinopril, enalapril and other adjuncts are strictly prohibited. The drug of choice remains verapamil at the lowest dose (1). All beta-blockers are canceled before the third trimester.

Antiepileptic drugs

Valproate And topiramate very effective, but prohibited during preparation for conception and pregnancy. There is no doubt about the teratogenicity of these drugs. Lamotrigine for the treatment of bipolar disorder is sometimes prescribed for migraines, and although the drug has a good safety profile in pregnancy, its effectiveness is no better than placebo (Antiepileptics for the prophylaxis of episodic migraine in adults).

Antidepressants

The use of the most correct tricyclic antidepressant is considered safe (10-25 mg per day). Its negative effect on pregnancy and the fetus has not been proven, but there is evidence of increased risk preeclampsia in women with depression taking it systematically.

However, amitriptyline has been suggested as a second-line choice after beta-blockers, as preventive measure. By the thirtieth week, any antidepressants are gradually canceled.

Dietary Supplements

Complementary (still the same alternative) medicine is not the best way to search safe ways remove a severe attack. But some of the usual safe substances that are not drugs can help in prevention.

Magnesium

It has a level B for proven effectiveness for the prevention of migraine (literally: Level B: Medications are probably effective). Safe during pregnancy (exception: intravenous administration for more than 5 days may affect the formation of the baby's bone tissue).

Researching material for this article, I found the latest meta-review of studies on magnesium in migraine therapy (2018) . Magnesium citrate(citrate) is still the most bioavailable (600 mg recommended dosage), the worst is oxide. The site has a separate article on the treatment of migraine with magnesium, which I will supplement with the latest data.

There is only one condition - magnesium works if there is a deficiency in cells. However, it is worth a try if the choice is between dietary supplements and heavy artillery.

Pyridoxine (Vitamin B6)

Reduces the number of seizures and significantly dulls nausea. Pyridoxine has been proven safe during pregnancy at very high doses in animals and has been approved by the FDA. The exact mechanism of action is not fully understood, more about this in the source. There are specific dosage recommendations: 80 mg of B6 per day or in combination with other 25 mg per day supplements (for example, folic acid/B12, or B9/B12).

Feverfew (tansy maiden)

A new substance with conflicting data on both efficacy and safety. Known more for the purified version of MIG-99. There is a risk of uterine contractions as long as feverfew is not recommended in recent reviews.

Coenzyme Q10

Level C: Efficacy not confirmed, but possible. There is evidence for the prevention of preeclampsia, so it is recommended as a dietary supplement (for some reason, the Canadian Headache Society especially recommends it).

Riboflavin (Vitamin B2)

Level B. Everyone knows him as a prophylactic for iron deficiency anemia. There is a recommended dosage for the treatment of migraine with riboflavin: 400 mg per day. For expectant mothers, the dosage may vary.

Melatonin

Based on several studies (no reviews yet), melatonin is safe and effective for treating migraines in pregnant women. The bioavailability of melatonin from drugs is still a big question. However, several small placebo-controlled studies have shown statistical significance of results compared to placebo and amitriptyline in attack prevention. If you have problems with sleep or circadian rhythms, why not try melatonin - it could be an alternative to antidepressants.

Nerve blockade with anesthetic injections

A method used in hopeless cases, with refractory migraine. The procedure is an alternative to combinations of anticonvulsants + antidepressants + opioids. Blockade of peripheral nerves is not uncommon now, but it is avoided by pregnant women. The West is accumulating more and more data on the blockade in pregnant women, the results are more than optimistic. In some cases, seizures do not return until six months.

Injections are given at one or more sites: the greater occipital nerve, auriculotemporal, supraorbital, and supranuclear nerve (1-2% lidocaine, 0.5% bupivacaine, or corticosteroids). Pain relief occurs immediately in 80% of cases. A small percentage of people do not help at all.

The procedure is more commonly known as an occipital nerve block. Lidocaine is safe, bupivacaine is conditionally safe (less data), and topical steroids are still being discussed. Of all the treatments for chronic headaches, lidocaine blockade is the most promising in the context of pregnancy.

Conclusions. Careful attention to the choice of drugs should already be at the planning stage. It is especially important to resolve the issue with preventive drugs that we take regularly - almost all prevention is gradually stopped even before conception. A little extra knowledge doesn't hurt, even if you have complete confidence in your doctor.

How to treat migraine while breastfeeding

The process of lactation protects against migraine up to 80% of women. If the attacks returned, it is much easier to control the condition during this period than during pregnancy. It is enough to know the concentration of the drug in milk and its ability to be absorbed by the baby.

Paracetamol considered the safest during breastfeeding. The concentration in mother's milk is low, the metabolism in babies is approximately the same as in adults. In the entire history of clinical observations, one case of a rash of a newborn (2 months) is known after exposure to paracetamol through mother's milk.

NSAIDs compatible with HBs, ibuprofen is recommended among the drugs of choice due to its short half-life (approx. 2 hours). Excretion into GM is low and no side effects have been reported. Diclofenac and naproxen should be taken with caution, feeding after taking after 4 hours. These are drugs of the second group of choice.

Irregular single doses of aspirin are acceptable, but in general, controversy does not subside around acetylsalicylic acid. The substance has high level excretion, affects the baby's platelets.

Triptans, even injectables, almost do not pass into mother's milk. But until the conservative precautionary measure has been canceled (valid since 1998) - a 12-hour break between taking and feeding. Given the half-life of sumatriptan of about 1 hour and the extremely low bioavailability, 12 hours is excessive. Most of contemporary research recommends resuming feeding after recovery from an attack.

Eletriptan has been little studied during pregnancy, but for lactation period it is preferred over sumatriptan. The fact is that the substance binds to plasma proteins and practically nothing reaches the GM. A dose of 80 mg eletriptan per day has been assessed to be completely safe.

Opioids as an emergency one-time assistance are acceptable, as they have a low concentration. We are always talking only about codeine, it is the weakest of all narcotic painkillers.

Ergotamine (ergot alkaloid) can't at all. This drug is very weak, and its side effects bring more problems than relief. Extremely high accumulation in milk, leading to cramps and dehydration.

Antiemetics, in particular metoclopramide, has an excretion slightly above average (it is unstable and depends on the mother's body: from 4.7 to 14.3%), but is allowed during breastfeeding unsystematically. side effects children were not registered.

Beta blockers can be returned after childbirth. Most reviews converge on the best studied metoprolol and propranolol. Highlight connections in breast milk low, up to 1.4% of the metabolized maternal dose, which is negligible even for preterm and low birth weight infants. This is good news, because some drugs need to be taken regularly.

Antiepileptic, prohibited during gestation, are allowed during lactation. Valproate almost does not reach GM - 1.7% max., Only trace amounts are found in the child's plasma. Topiramate gives a concentration of up to 23%, and despite the fact that it is considered compatible with breastfeeding, control is necessary in the youngest children: irritability, weak sucking reflex, diarrhea.

Antidepressants, in particular amitriptyline, can be used as migraine prophylaxis when first-choice drugs (beta-blockers and dietary supplements) do not work. Compatible with HB, the level of the substance in milk is low - up to 2.5% of the mat. doses. The child's plasma level is below detectable or trace. Other antidepressants are not considered, as their half-lives are much longer and they can theoretically accumulate in the baby's body (data as such are not available).

Byly, enalapril in particular, are nephrotoxic to neonates. Their excretion is extremely low - up to 0.2%, but given that enalapril is taken daily, it is considered incompatible with HB. Some sources speak of taking "with care and control."

Magnesium and riboflavin may be taken additionally. Their number in the GM increases slightly.

Conclusions. All effective drugs for the treatment of severe migraines are compatible with breastfeeding, as they are not transmitted in mother's milk in pharmacologically significant amounts. After reading dozens of reviews and studies, I have never come across recommendations about pumping, but this choice always remains with the mother.

Sources and literature

I want to draw attention to the sources of information. All articles and meta-reviews to which I refer are published in peer-reviewed clinical journals. The most important and fresh materials are placed in a separate folder on Google Drive with free access.

You have the opportunity to familiarize yourself with the original source yourself, the documents have:

Full texts in the original, downloaded from sci-hub (with footnote numbers assigned in the article (1-11) and links to them).
Machine translation of every original article and review I link to (but without tables, they are very difficult to translate and format).

IN original materials contains a lot of useful information about different types headaches in pregnant women, not everything can fit into one article. I always recommend referring to the original source, even if you trust the author of the Russian-language text. You may need guidance on how to find medical information.

I hope the work done will be useful to someone.

Migraine is a common form of headache during pregnancy. Its provocateurs can be various violations vascular system, lack of rest, hormonal imbalance, stress, poor nutrition and many other factors. Migraine is characterized by throbbing and severe pain in the head, as well as the appearance of visual disturbances and nausea. Such discomfort greatly worsens the well-being of a woman and not the most in the best way affects pregnancy. But the biggest difficulty in this situation is the fact that all migraine remedies during pregnancy are contraindicated. To understand this issue, let's find out what causes migraines during pregnancy, how to treat this ailment and how a headache can affect the fetus.

Headache can be different and occurs for many reasons. Migraine is just one of the types of headache and is the result of neurological disorders of a chronic nature.

Migraine is paroxysmal in nature. The next paroxysm (attack) is preceded by certain symptoms (aura), and then intense pain begins at one point of the head, more often in the area of the temples or forehead. The pain is accompanied by a strong sensitivity of the senses to light, aroma, noise. Sometimes an attack can cause vomiting, dizziness, and fainting.

The disease can occur when conditions favorable for it appear, for example, after overheating in the sun, taking hormonal pills, with nervous shock or chronic fatigue.

Migraine is hereditary. Medical experience shows that the risk of migraine increases by 70% if the mother had this disease.

Migraine refers to chronic diseases, so it requires complex treatment, which consists of taking painkillers during an attack and drugs that stabilize general state health. If a woman is in a position, the treatment is selected the most benign, so as not to harm the baby. Therefore, if a woman suffers from migraine during pregnancy, only a doctor should decide how to treat another attack.

Possible complications of the disease are migraine stroke, which is accompanied by serious neurological disorders (facial paralysis) and frequent prolonged attacks of pain.

During pregnancy, recurring seizures can harm the baby as the woman suffers from dehydration and oxygen deficiency. Besides, frequent vomiting and severe exhaustion of a woman can provoke a miscarriage or stop the development of the fetus.

Causes of migraine during pregnancy

Scientists and doctors have not yet established what provokes the development of migraines. But studies and long-term observations prove that this disease affects people aged 18 to 30 years, and 70% of them are women. Therefore, the incidence of migraine during pregnancy is about 20%.

Pregnancy is considered a migraine trigger for two reasons. On the one hand, against the background of changes in the hormonal status, the nervous system becomes vulnerable to any external stimuli. On the other hand, increased load on the kidneys and increased blood volume directly affect the cardiovascular system. Therefore, such conditions make a woman prone to migraine attacks.

There are a number of reasons for the development of a migraine attack:

A sharp lack of night rest.
Decreased blood sugar concentration.
fluid deficiency.
Weather sensitivity.
A radical change in the daily routine without preparation.
Reaction to environmental stimuli - unpleasant odor, closeness in the room, loud music.
Abuse of caffeinated products.
Low pressure.
High stress conditions.

Migraine can be due to poor functioning internal organs. So with pancreatitis or liver damage, headache attacks can constantly occur without any precursors and disappear just as instantly.

Another cause of migraine is general intoxication. For example, SARS, poisoning, chronic infections constantly fill the body with toxins, which leads to constantly recurring headaches.

Migraine is a constant companion of diabetes. Therefore, this diagnosis should also be ruled out if migraine occurs during gestation.

Migraine attacks during pregnancy can be the result of other dangerous diseases such as meningitis, glaucoma, brain tumors and sinusitis. Therefore, if there is any severe pain in the head, it is very important to consult a doctor.

Mostly migraine appears in the first half of pregnancy. But there are exceptions when an attack may appear later. The reason for this may be the load on the spine, preeclampsia, hypertension and excess weight.

migraine symptoms during pregnancy

The main symptom of migraine is a severe pain syndrome in the head area, which resembles intense pulsation, a feeling of squeezing, tingling, knocking. The pain can be localized in the frontal-temporal part, or "migrate" along the head towards the back of the head. The place of pain can constantly change from attack to attack.

The frequency of migraine pains is different. Some women may have 1-2 seizures during their entire pregnancy, while others may have 3-4 attacks per week. The pain syndrome can last from 3 hours to several days with short periods of relief.

The next attack of migraine is preceded by certain symptoms, which are called migraine aura. This may be a change in smell, flickering before the eyes, irritability, loss of strength, loss of appetite.

If a woman experienced migraine attacks before pregnancy, then after conception, the frequency and intensity of migraine in early pregnancy can increase dramatically. But closer to the middle of pregnancy, the disease weakens.

You can distinguish a migraine from another type of headache by the following signs:

The pain is concentrated at one point (forehead, supraocular part, temple, occiput).
The pain is accompanied by bouts of nausea, salivation, intolerance to light and loud sounds.
Any physical activity makes the migraine worse.
The pain is like a pulse.
Analgesics do not help relieve pain.
The attack is preceded by a migraine aura.
Pain completely reduces daily activities.
Parents also have migraine attacks.

A migraine attack always occurs in three phases:

The first phase starts 20-60 minutes before the attack. A woman's mood disappears for no reason, she becomes lethargic, lifeless, she wants to sleep, a feeling of fullness in her head slowly grows, and pain appears.
The second phase is the peak of the headache. The woman has a strong pulsation in the temples, vomiting appears, the skin on the face turns pale, swelling of the eyelids may occur. Such a long and severe migraine during pregnancy requires urgent hospitalization.
The third phase falls on the decline of the headache. The woman becomes upset, exhausted, drowsy. Rarely, a migraine attack may recur at this stage. At the same time, a woman’s weakened body may be subject to such complications as cerebral hypoxia, convulsions, and dehydration.

Migraine during pregnancy: drug treatment

It is almost impossible to eliminate a migraine headache with conventional analgesics. Ergotamines are mainly used to alleviate the condition. But the treatment of migraine in women in position is very limited, because many of this group of drugs are toxic to the fetus, especially in the first 2-3 months. They can influence the development chromosomal abnormalities, cause uterine contractions and miscarriage, provoke bleeding.

Migraine pills during pregnancy

With a mild migraine attack, pregnant women are prescribed the simplest and conditionally safe analgesic, for example, Citramon or Paracetamol in low doses.

If a pregnant woman is diagnosed with migraine status (attacks are repeated more than 15 times a month), she is prescribed antidepressants and beta-blockers. Some of them are allowed during gestation and do not adversely affect the fetus. These include Labetalol, Amitriptyline, Propranolol and Fluoxetine.

Acupuncture for migraine during pregnancy

Acupuncture is safe and active agent from migraine during pregnancy. The placement of needles brings quick relief during the next attack by blocking the passage of nerve impulses along the painful pathways. At the same time, the need to take harmful analgesic drugs disappears.

This method is allowed in the first trimester, but before the procedure, you need to consult a gynecologist and a neurologist. If there are no contraindications, then several courses of acupuncture between attacks will help restore the disrupted functioning of the vascular system and achieve a stable remission in a woman.

Treatment of migraine during pregnancy folk remedies

What should a woman do in a position if medications are contraindicated and the pain is very severe? In this situation, you can use one of the safe folk methods. They will help you feel better before you visit the doctor.

A mug of hot and very sweet tea will help to increase the level of glucose and bring the vascular tone back to normal. But here it is important to understand that in the presence of gestational diabetes, this method is contraindicated.
For many centuries, headaches have been relieved with the help of a cabbage leaf. You need to attach it to the sore spot and fix it with a handkerchief.
Ice helps to reduce pulsation. You need to wrap it in a bag and soft tissue and apply to the painful area for a couple of minutes. Do not apply ice yourself, as you can freeze the scalp.
A decoction of dill seeds has an analgesic effect. You need 1.5 tsp. brew seeds in 250 ml of boiling water for 2 hours and then drink the infusion.
Massage can help stop a migraine attack. It is not necessary to call a professional massage therapist, you can ask someone close to massage your head, neck, temples. This will improve blood circulation and double the supply of oxygen to the brain. All massage movements should be gentle, circular, not sharp.
Stay on fresh air It also helps to normalize blood pressure and reduce pain. But when the migraine is in active phase It's very difficult to go outside. To solve this dilemma will help intensive and regular airing rooms, suitable mode air conditioning or relax on the balcony, veranda.
An herbal relaxation pillow will help prevent another migraine attack. To make it, you need to take part of the bay leaf, part of the cherry leaves and part of the eucalyptus, and then fill the pillowcase with the herbal mixture and sew it up. You can rest on a pillow for 3-4 hours a day.
Another great anti-migraine recipe is a thyme compress. It is necessary to pour a handful of grass with a small amount of boiling water to make a slurry. Then you need to wrap the grass in a clean cloth and apply it to your forehead and temples.
You can improve your well-being with lavender tea. It is very easy to prepare it: pour 10 g of inflorescences with a glass of boiling water and let the tea brew for 15 minutes.

Migraine during pregnancy: what to do to prevent attacks

Migraine is often provoked external factors, therefore, it is quite possible to reduce the frequency of occurrence of pain if you adjust your lifestyle. It is important to exclude all factors that can irritate the nerve center and have a bad effect on the vascular system.

So, instructions on how to get rid of migraines during pregnancy:

Isolate yourself from psychological discomfort - eliminate stress, unpleasant communication, unloved activities.
Together with your doctor, make a list of foods that can provoke migraine attacks (usually citrus fruits, coffee, cocoa.)
Get enough rest, get enough fresh air, avoid noisy places with bright lights.
Be sure to get diagnosed of cardio-vascular system(this can be done during pregnancy).
Learn to recognize the aura in order to calm down and rest in advance. This will reduce the intensity of the pain attack.
Discover yoga. Relaxation exercises are great for restoring the nervous system.
Do not neglect visits to the doctor. Always check with your gynecologist what you can get from migraine during pregnancy and what is prohibited.
With an increase in migraine-like headache, a pregnant woman should immediately take action: put out bright lights, turn off the TV and other sound sources, ventilate the room from the smells of food, tobacco smoke, perfume, sit comfortably on the bed and relax.

Love yourself and enjoy your pregnancy. Because positive energy is the best prevention any headache and other illnesses.

Video "Treatment of migraine during pregnancy"

Migraine during pregnancy is a common ailment for expectant mothers. Pain can be caused by dysfunctions of the heart and blood vessels, lack of rest, hormone surges, stressful situations, malnutrition. Symptoms of migraine - throbbing and severe headache, vision problems and nausea. In the early stages, malaise is usually associated with changes in hormonal levels and the work of the cardiovascular system in an enhanced mode. In the later stages - with meteorological dependence, load on the spinal column. Almost all medicines against migraine during pregnancy are prohibited. What will help remove discomfort: Cold compress. At the time of the attack, apply ice wrapped in a cotton cloth to the forehead. Cabbage leaf. Remember it and press it to the painful area, strengthen it with a bandage or a cotton scarf. The compress must be kept until it disappears completely. pain syndrome. Instead of cabbage, you can take an onion, peeled and cut in half. Orange, lemon, lavender, lemon balm essential oils. They need to be inhaled during an attack. Relieves pain and light head massage with a brush. To do this, the hair must be combed first in one direction, then in the other. How to relieve a migraine caused by drops blood pressure depends on whether it went up or down. In the first case, drink hot sweet tea, in the second - tea with lemon. As for decoctions of medicinal plants, one must be careful with them. The active substances in their composition can cause a miscarriage or have a negative impact on the condition of the fetus. To reduce the risk of excruciating pain, you need to get enough sleep, and ventilate the room before going to bed. Walk regularly in parks and squares, eliminate stress, dehydration, overheating and hypothermia. If nothing helps, consult your doctor. He will be able to pick up acceptable drugs.

Pregnancy is not only a joyful event for every woman, but also a serious test for the body. During the period of bearing a baby, many of the fair sex experience various health problems.

For example, some may get migraines during pregnancy, although before that they may not have known about the existence of such an ailment.

Migraine is manifested by a headache, it can be both moderate and unbearable. Most drugs for this ailment should not be taken during pregnancy, but then how can expectant mothers treat migraines?

Before treating a headache, it is necessary to understand the causes of its occurrence. In some cases, migraine can be caused by several factors at once. If pain sensations appear regularly, then you need to conduct an examination in order to know exactly the reasons that provoked a migraine. Consider the most common of them:

Hormonal disbalance. During the period of gestation, the amount changes female hormones. As a result, all this has strong impact to work nervous system. Most often, migraine worries at the very beginning of the term, since at this time the body adapts. In this case, doctors usually do not prescribe any treatment. But if a woman has severe migraine attacks during pregnancy, then the doctor may prescribe the necessary drugs to help relieve the symptoms. Otherwise, a strong pain syndrome may threaten normal course pregnancy.
Hypertension. Blood pressure usually rises late term as the volume of circulating blood increases. And if the fair sex has suffered from high blood pressure before, then she should be engaged in the prevention of this condition from the very beginning of pregnancy. Sometimes the cause of high blood pressure is kidney disease. In any case, with hypertension, the doctor should prescribe the patient medications that lower blood pressure, which will not harm the fetus. Apart from drug treatment provoking factors should be excluded, namely: physical and nervous stress, and you also need to eat right and get more rest.
Hypotension. Blood pressure may decrease due to the predominance of the hormone progesterone in the body during pregnancy. It has a tonic effect. As a result of a decrease in muscle tone, blood vessels dilate, so blood pressure decreases. The pain syndrome appears due to the fact that the brain does not have enough oxygen. Whether treatment is necessary in this case should be decided by the doctor. But drugs containing caffeine are usually prescribed. But you can raise blood pressure without medication, for example, drink coffee, if there are no contraindications.
The emergence of new diseases. Meningitis, sinusitis, diseases of the eyes, kidneys, encephalitis - all these diseases can also be accompanied by migraines. If they appear during the bearing of the baby, then the woman needs emergency treatment. In addition, as a complication of pregnancy, preeclampsia can occur - this is a generalized vasospasm, which leads to an increase in blood pressure. In this case, the woman experiences unbearable pain, may even lose consciousness.
Exacerbation of chronic diseases. Migraine during pregnancy happens that occurs due to problems with the spine. Similar diseases usually worsen during the period of bearing a baby, as the load on the spine increases. Osteochondrosis or vegetovascular dystonia may appear - these diseases are also manifested by a headache.
Wrong nutrition. If you overeat during pregnancy, then a significant weight gain can cause an increase in blood pressure. And if, on the contrary, a woman is malnourished, then the lack necessary for the body trace elements and vitamins can lead to headaches. That is why you need to eat right, better often, but in small portions.
stress factor. nervous tension, fears, quarrels - all these factors can cause a migraine in a pregnant woman. It can also be caused by hard work at the computer or a change in the weather. woman in this important period should take care of themselves and avoid various stressful factors.

Treatment without pills

Taking many medications during pregnancy is prohibited, so women are looking for other ways to get rid of migraines. First of all, it is necessary to avoid factors that can provoke it:

overwork and lack of sleep;
the use of large quantities of citrus fruits, chocolate, spices and cheese;
lack of fluid in the body, happens in the first trimester;
allergy;
response to weather changes.

Folk recipes

Some women for some reason do not consider a headache serious reason to see a doctor, so they are trying to find ways to get rid of it at home. In this case, it comes to the rescue ethnoscience. But if migraine occurs frequently, it is better to consult a doctor.

Consider the popular proven recipes with which our grandmothers got rid of migraines:

Ice packs. You can apply an ice bag to the head, thus, the tone of the dilated vessels will be restored and the condition will improve. But this procedure must be carried out carefully, the compress cannot be kept for a long time, but you can catch a cold. It is recommended that you wrap a towel around the ice pack before applying it to your forehead.
Cabbage leaf. You need to take a fresh cabbage leaf and pour boiling water over it, and then attach it to your head and wrap it with a woolen scarf. This remedy is simple but quite effective.
Sweet tea. You can brew fresh tea, add sugar to it and drink it. This recipe may have its contraindications. Caution should be taken when drinking strong tea during the first trimester of pregnancy.
Decoction of herbs. If there are no contraindications, then you can brew a decoction of herbs: lemon balm, chamomile and mint. But before using the collection, it is better to consult a doctor.

Relaxation techniques

If you suffer from migraine during pregnancy, then you can try various relaxation techniques. These include yoga and meditation. In addition, acupuncture can help - it is quite safe and effective method getting rid of headaches.

There is one more nice way, which is used to get rid of migraines is aromatherapy. But it should be used if future mother no allergies to essential oils. Exhaling the aromas of essential oils improves blood circulation in the nerve endings and promotes relaxation. The following oils are suitable for these purposes: basil, rose, lemon, eucalyptus, mint and rosemary.

Massage

Back, neck and head massage great way relieve stress and relax. But unfortunately, professional massage may not be available to everyone, so you can learn the basics and do it yourself. Consider the three main "migraine" points that need to be massaged for 10 seconds 10 times:

The first point is located between the eyebrows in the middle of the forehead.
The second point is located on the feet at the point of convergence of the bones of the thumb and second toe.
The third point is located at the deepening of the bone behind the corners of the eyes.

Execution rules:

Acupressure should be done with fingertips.
The pressure on the point should be moderate, but not very strong.
It is necessary to perform circular movements, gradually pressing on the point.
If the massage is done correctly, then the person will feel how the muscle tension goes away.
Session ends in a circular motion, which gradually slow down until they stop altogether.

Medical treatment

If you are worried about migraine attacks during pregnancy and the above remedies do not help, then you should consult your doctor before taking any medicine for headaches.

Especially dangerous are migraine drugs at the beginning of the term, as they can damage the fetus. But already in the second trimester, the placenta protects the fetus and prevents drugs from penetrating through it. During this period, a woman, if an unbearable headache occurs, can take Paracetamol or other medicines containing this substance.

Although this drug is antipyretic, it still has a slight analgesic effect. In addition, it is less harmful than other drugs, it is even prescribed to infants.

If the expectant mother has problems with blood circulation, then the doctor can prescribe Actovigin for her. It will help to cope with a headache and eliminate the causes of its occurrence.

In addition, you can try to get rid of pain with the Chinese ointment "Asterisk". She needs to rub her temples, and then she should wrap her head with a woolen scarf. But before using, you should make sure that there is no allergy to its components.

In the event that migraine attacks during pregnancy are caused by pressure surges, then appropriate drugs should be prescribed by the doctor, because they can be dangerous for both the mother and the child. But if the intensity of the pain syndrome is so strong that there is no urine to endure, then you can take the No-shpy pill.

Can't take medicine, which contain acetylsalicylic acid, this includes all derivatives of a drug such as Aspirin. Also, the list of prohibited drugs during pregnancy includes "Analgin" and all its derivatives. It is very toxic to the fetus and even in small doses can cause changes in blood quality.

To date, there are still drugs that are used specifically for the treatment of migraine, but they are prescribed exclusively by a doctor. Some of them can even be used during pregnancy.

When should you go to the doctor?

Migraine attacks in pregnant women are quite common, as a rule, they do not pose a serious health hazard. But sometimes there are cases when it is simply necessary to visit a doctor, for example:

migraine attacks disturb regularly;
the nature of the pain syndrome has changed;
it is localized in some particular part of the head;
accompanied by jumps in blood pressure;
in addition to pain, symptoms such as speech, hearing, vision disorders, numbness of the extremities, increased sensitivity to light and sounds, and vomiting appeared.

If the above symptoms occur, it is imperative to undergo an examination, otherwise there may be serious problems with health.

During pregnancy, a woman must take care of herself! You need to eat right and balanced, sleep at least 8 hours a day, walk in the fresh air and relax. It is especially recommended to avoid stress, as well as increased mental and physical stress.