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妊娠和哺乳期偏头痛的关系及治疗方法

Relation and Treatment Approach of Migraine in Pregnancy and Breastfeeding.

作者信息

Turankar Tileshkumar, Sorte Akshayata, Wanjari Mayur B, Chakole Swarupa, Sawale Shantanu

机构信息

Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2023 Mar 28;15(3):e36828. doi: 10.7759/cureus.36828. eCollection 2023 Mar.

Abstract

Headaches are one of the most frequent reasons people visit the neurology department. In 2019, headache issues ranked as the 14th most common cause of disability-adjusted life years globally. According to the International Headache Society, migraine is a particular type of headache that is unilateral, frequently throbbing, associated with vertigo, and sensitive to light, sound, and head movement. A migraine has four stages: premonitory, aura, headache, and postdrome. Migraine is the type of discomfort that most frequently complicates the pregnancy. A migraine is more common in women than in men. Migraines are influenced by increased levels of estrogen during pregnancy and a sharp decrease in those levels during puerperium. Untreated migraine can result in premature labor, hypertension, and low birth weight babies. Menstrual-related events occurred more frequently in migraine sufferers than in non-migraine sufferers. We have explained the relation of sex hormones that trigger migraine. We have also reviewed the therapeutic approach, such as pharmacological and non-pharmacological approaches, for migraine in pregnancy and breastfeeding. A migraine episode during menstruation was slightly more severe and complicated than a headache that wasn't a migraine. Breastfeeding is not prohibited by migraines. The steady estrogen levels brought on by lactating women's lack of menstruation may function as a protective factor. In addition to any required drug therapy, nonpharmacological techniques should always be used as the first line of treatment. Preconception counseling is an essential part of providing headache patients with safe therapy during pregnancy. Supplemental estrogen should not be used by any women who have an aura or who are 35 years of age or older because there is inadequate proof to support any long-term adverse effects. Paracetamol is advised for use in acute therapy during pregnancy. Mothers who used acetaminophen during pregnancy are more likely to have children with hyperkinetic disorders and characteristics resembling attention-deficit/hyperactivity disorder. Menstrual migraine can be treated in a variety of ways, including acute therapy, non-pharmacological therapy, and preconception counseling. Similar tactics are used to treat migraines during pregnancy, but it's important to take the medications' safety rating into account. Migraines and menstrual problems go together. A safeguarding element is a constant estrogen level during pregnancy and breastfeeding. The preferred method of treatment for migraine is non-pharmacological therapy, followed by prenatal counseling. Sumatriptan and acetaminophen are both effective treatments for transient migraine attacks that occur during pregnancy or breastfeeding.

摘要

头痛是人们前往神经科就诊的最常见原因之一。2019年,头痛问题在全球残疾调整生命年的常见病因中排名第14位。根据国际头痛协会的定义,偏头痛是一种特殊类型的头痛,具有单侧性、频繁搏动性、伴有眩晕,且对光线、声音和头部运动敏感。偏头痛有四个阶段:前驱期、先兆期、头痛期和恢复期。偏头痛是孕期最常出现并发症的不适类型。女性比男性更易患偏头痛。孕期雌激素水平升高以及产褥期雌激素水平急剧下降会影响偏头痛。未经治疗的偏头痛可能导致早产、高血压和低体重儿。偏头痛患者月经相关事件的发生率高于非偏头痛患者。我们已经解释了引发偏头痛的性激素之间的关系。我们还回顾了孕期和哺乳期偏头痛的治疗方法,如药物治疗和非药物治疗。月经期间的偏头痛发作比非偏头痛性头痛略为严重和复杂。偏头痛并不禁止母乳喂养。哺乳期女性因停经而保持稳定的雌激素水平可能起到保护作用。除了必要的药物治疗外,非药物技术应始终作为一线治疗方法。孕前咨询是为头痛患者在孕期提供安全治疗的重要环节。有先兆或年龄在35岁及以上的女性不应使用补充雌激素,因为没有足够证据支持其长期不良反应。建议在孕期急性治疗时使用对乙酰氨基酚。孕期使用对乙酰氨基酚的母亲所生子女更易患多动障碍及具有类似注意力缺陷/多动障碍的特征。月经性偏头痛可通过多种方式治疗,包括急性治疗、非药物治疗和孕前咨询。孕期偏头痛的治疗采用类似策略,但重要的是要考虑药物的安全评级。偏头痛与月经问题相伴。孕期和哺乳期稳定的雌激素水平是一个保护因素。偏头痛的首选治疗方法是非药物治疗,其次是产前咨询。舒马曲坦和对乙酰氨基酚都是治疗孕期或哺乳期短暂性偏头痛发作的有效药物。

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