DIFFERENTIATED APPROACH TO THE MANAGEMENT OF PREGNANT WOMEN WITH MIGRAINE: BALANCE OF EFFICACY AND SAFETY
Keywords:
migraine, pregnancy, differentiated approach, risk stratification, pharmacotherapy, non-pharmacological treatment, safety, personalized therapyAbstract
Treatment of migraine in pregnant women is a complex clinical challenge that requires an optimal balance between therapeutic efficacy and safety for mother and fetus. This article presents a differentiated approach to the management of pregnant women with various types and severity of migraine based on current clinical guidelines and evidence base. The features of risk stratification, methods for evaluating the effectiveness and safety of pharmacological and non-pharmacological treatment methods depending on the trimester of pregnancy, clinical form of migraine, and presence of comorbidities are considered. Particular attention is paid to a personalized approach, taking into account the individual characteristics of patients, previous treatment experience, and preferences of the pregnant woman.
References
Amundsen S., Nordeng H., Nezvalová-Henriksen K., et al. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol. 2021; 17(9): 551-562.
Negro A., Delaruelle Z., Ivanova T.A., et al. Headache and pregnancy: a systematic review. J Headache Pain. 2022; 23(1): 67.
MacGregor E.A. Migraine in pregnancy and lactation. Neurol Sci. 2021; 42(Suppl 1): 69-77.
Dodick D.W., Silberstein S.D., Bigal M.E., et al. Differentiated treatment of migraine: evidence-based strategies for effective management. CNS Drugs. 2023; 37(1): 1-19.
Мумладзе Э.Б., Амелин А.В. Мигрень и беременность: современные подходы к диагностике и лечению. Неврология, нейропсихиатрия, психосоматика. 2022; 14(3): 76-82.
Skajaa N., Szépligeti S.K., Xue F., et al. Pregnancy, birth, neonatal, and postnatal neurological outcomes after pregnancy with migraine. Headache. 2023; 63(2): 208-219.
Екушева Е.В. Мигрень у женщин: влияние гормонального фона. Неврология, нейропсихиатрия, психосоматика. 2020; 12(4): 126- 132.
Galletti F., Galletti F., Boldrini P., et al. Migraine and pregnancy: an updated review. J Matern Fetal Neonatal Med. 2022; 35(25): 5094-5101.
