Migraine with Aura Management During Pregnancy
Managing acute migraine with aura during pregnancy requires careful selection of treatments, as both trimester and the potential for fetal exposure shape which options are appropriate.
Clinical scenario
This protocol addresses migraine with aura attacks occurring during pregnancy. The choice of acute treatment must account for trimester-dependent safety considerations and individual contraindications.
Treatment approach
Certain analgesic agents are appropriate for acute attacks in the first and second trimesters, while the third trimester carries additional restrictions. Some agents are reserved for cases where first-choice options are contraindicated, and at least one drug class is contraindicated throughout pregnancy. The complete sequenced regimen — including which agents apply at each stage and under what conditions — is in the full protocol.
References
DOI: 10.1177/2514183X1882337
- Migraine attacks can be treated between the first and second trimenon of pregnancy with ASA or ibuprofen. These substances should be avoided in the third trimenon.
- Paracetamol should only be given if there are contraindications for ASA.
- Sumatriptan should only be taken by pregnant women when the expected benefit for the mother outweighs a possible risk for the child.
- Ergots are contraindicated during pregnancy.