| Many women who have migraines and headaches | | | | time. Most OB/GYN's and primary care physicians |
| seem to watch their head pain disappear during | | | | would agree. |
| pregnancy. Almost 70% of women with a history of | | | | HOWEVER...if your headaches are so severe the |
| migraine headaches improve during this time. | | | | Tylenol with codeine, or even Lortab, is not working, |
| Unfortunately, 30% don't improve. They stay the same | | | | then you should see a headache specialist. ONLY A |
| or get worse. Let's be clear..I am talking about | | | | NEUROLOGIST, working with your OB/GYN should |
| moderate to severe headaches that are not relieved | | | | determine if you can have a triptan during pregnancy. |
| by Tylenol. | | | | Although medication should be avoided during |
| The headache in pregnancy may become more | | | | pregnancy, if the risk to you is greater then the |
| frequent and more severe as estrogen levels rise in | | | | condition should be treated. Severe pain of chronic |
| the first trimester. If you are one of these women, you | | | | headache increases adrenaline levels. This increases |
| might improve if under the care of both your OB/GYN | | | | the baby's heart rate and your blood pressure rises. |
| and a neurologist. | | | | Occasionally, we do prescribe daily medication for |
| If this is a new onset of headaches or migraines then | | | | mothers who have severe pain with nausea and |
| this could be an emergency. Please call your doctor | | | | vomiting. This should be guided by both your OB/GYN |
| and tell them if you have headaches you've never had | | | | and your headache specialist. |
| before. A moderate to severe headache in pregnancy | | | | MRI and CT Scans During Pregnancy |
| should be taken seriously. High blood pressure during | | | | Many people ask me about MRI's, CT scans and being |
| pregnancy can be serious and could cause a bad | | | | pregnant. You should not have a CT of the brain while |
| headache. Conditions such as this are bad for the | | | | pregnant. This is a form of X-Ray and is not good for |
| mother and the baby. | | | | the forming fetus. |
| Treatment of Migraine in Pregnancy | | | | But, if a doctor deems it is necessary you can have |
| As mentioned, these headaches can be severe. If | | | | an MRI or MRA of the brain. MRI's use magnetic fields. |
| accompanied by nausea and vomiting that should be | | | | MRA's are similar but only look at the arteries in the |
| treated too to avoid stress on the baby. Tylenol with | | | | brain, not the brain itself, like MRI's. MRI's are not |
| codeine is the drug of choice during the first trimester, | | | | generally done when you are pregnant and we do not |
| to be used at the onset of the migraine. Additionally, | | | | do them if the diagnosis is clear cut..such as a |
| you can be on daily medication during this time. We | | | | recurrence of migraines. But if needed, we do them |
| usually place our patients on Inderal (propranolol) low | | | | right away. Rarely, I have seen brain tumors and |
| dose, 10-20mg per day to start. Usually a low dose like | | | | aneurysms (out pouching of arteries) in pregnancy. |
| this is sufficient. Rarely, we do use low doses of an | | | | Remember, medical intervention is warranted if the |
| anti-seizure drug and although these medications are | | | | health of the mother is at risk. If you are in trouble, the |
| not recommended for pregnancy, once again the risk | | | | baby is in trouble. |
| to the both the mother and baby must be weighed. | | | | Speak to your provider about your headaches. |
| Can you have triptans, like Imitrex, while you are | | | | Headaches and pregnancy is not something to just be |
| pregnant? We get this question alot and generally | | | | endured. This should be one of the happiest times of |
| speaking NO you cannot take your triptan during this | | | | your life, not one of the most miserable. |