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Neurological Sciences
Published in: Neurological Sciences 1/2019

01-05-2019 | Migraine | Review Article

Migraine during pregnancy and in the puerperium

Authors: Gianni Allais, Giulia Chiarle, Silvia Sinigaglia, Ornella Mana, Chiara Benedetto

Published in: Neurological Sciences | Special Issue 1/2019

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Abstract

Pregnancy can be seen as a positive time for women migraineurs because the elevated estrogen and endogenous opioid levels raise the pain threshold and the stable hormone levels, which no longer fluctuate, eliminate a major trigger factor for the attacks. In a great majority of cases, indeed, migraine symptoms spontaneously improve throughout pregnancy. Generally, migraine without aura (MO) improves better than migraine with aura (MA), which can occur ex novo in pregnancy more frequently than MO. After childbirth, the recurrence rate of migraine attacks increases, especially during the first month; breastfeeding exerts a protective effect against the reappearance of attacks. Migraine and pregnancy share a condition of hypercoagulability; therefore, attention must be paid to the risk of cardiovascular disorders, like venous thromboembolism and ischemic or hemorrhagic strokes. Some of these diseases can be linked to preeclampsia (PE), a serious complication of pregnancy, characterized by hypertension, proteinuria, or other findings of organ failure. This condition is more common in migraineurs compared with non-migraineurs; furthermore, women whose migraines worsen during pregnancy had a 13-fold higher risk of hypertensive disorders than those in which migraine remitted or improved. Pregnancy is generally recognized to exert a beneficial effect on migraine; nonetheless, clinicians should be on the alert for possible cardiovascular complications that appear to be more frequent in this patient population.
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Metadata
Title
Migraine during pregnancy and in the puerperium
Authors
Gianni Allais
Giulia Chiarle
Silvia Sinigaglia
Ornella Mana
Chiara Benedetto
Publication date
01-05-2019
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue Special Issue 1/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-019-03792-9

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