Book contents
- Emergency Headache
- Emergency Headache
- Copyright page
- Contents
- Contributors
- Preface
- 1 Introduction
- 2 Epidemiology of Headache in the Emergency Department
- 3 Approach to History Taking and the Physical Examination
- 4 Approach to Investigations
- 5 Thunderclap Headache in the Emergency Department
- 6 Other Secondary Headaches in the Emergency Department
- 7 The Migraine Patient in the Emergency Department
- 8 The Patient with a Trigeminal Autonomic Cephalalgia in the Emergency Department
- 9 Other Primary Headache Disorders That Can Present to the Emergency Department
- 10 Medication Overuse Headache in the Emergency Department
- 11 Approach to the Pediatric Patient with Headache in the Emergency Department
- 12 Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
- 13 Approach to the Elderly Patient with Headache in the Emergency Department
- 14 Preventing Emergency Department Visits in Primary Headache Patients and Prevention of Bounce-Backs to the Emergency Department
- Index
- References
12 - Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
Published online by Cambridge University Press: 09 October 2017
- Emergency Headache
- Emergency Headache
- Copyright page
- Contents
- Contributors
- Preface
- 1 Introduction
- 2 Epidemiology of Headache in the Emergency Department
- 3 Approach to History Taking and the Physical Examination
- 4 Approach to Investigations
- 5 Thunderclap Headache in the Emergency Department
- 6 Other Secondary Headaches in the Emergency Department
- 7 The Migraine Patient in the Emergency Department
- 8 The Patient with a Trigeminal Autonomic Cephalalgia in the Emergency Department
- 9 Other Primary Headache Disorders That Can Present to the Emergency Department
- 10 Medication Overuse Headache in the Emergency Department
- 11 Approach to the Pediatric Patient with Headache in the Emergency Department
- 12 Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
- 13 Approach to the Elderly Patient with Headache in the Emergency Department
- 14 Preventing Emergency Department Visits in Primary Headache Patients and Prevention of Bounce-Backs to the Emergency Department
- Index
- References
Summary
Most pregnant women with migraine improve during pregnancy, though migraine can resume following delivery and during breastfeeding. Since many women limit their exposure to drugs during pregnancy or breastfeeding, a migraine may be undertreated, become severe, refractory, and result in the need for an emergency department (ED) visit during this period. As with non-pregnant women, early management requires differentiation between primary and secondary headache, and though most headaches evaluated in the ED are migraines, some patients will need imaging or specialty consultation for this determination. Drug safety during pregnancy and lactation will limit the use of some drugs used in the treatment of migraine. Medications for acute treatment of refractory migraine in pregnant or lactating women are discussed and include dopamine antagonists, nonsteroidal anti-inflammatory medications, magnesium, opioids, triptans, and corticosteroids. Recommendations for medication use are made on the basis of risk of the drug to a pregnant woman or nursing infant and evidence for efficacy in the ED population.
- Type
- Chapter
- Information
- Emergency HeadacheDiagnosis and Management, pp. 125 - 140Publisher: Cambridge University PressPrint publication year: 2017