Newswise — NEW YORK (June 26, 2013) – Most pregnant women hospitalized and treated for acute severe migraines were able to successfully deliver full-term babies vaginally, according to a new study by researchers at Montefiore Headache Center. Common pharmacologic treatments used were oral acetaminophen and intravenous metoclopramide. These data will be presented at the International Headache Congress (IHC) on June 28 in Boston.
In this retrospective study of 29 patients with acute migraine during pregnancy without secondary headache, 75.9 percent of patients had full-term vaginal deliveries. Pre-term deliveries occurred in 17.2 percent of patients, which is slightly higher than 11.4 percent seen in the general public. Follow up was not possible for the remaining 6.9 percent.
“Acute migraine during pregnancy is a challenging condition for physicians to treat due to fears of harming the fetus and limited clinical research in the area,” said Matthew Robbins, M.D., director of Inpatient Services, Montefiore Headache Center, chief of Neurology, Einstein Division, Montefiore, and assistant professor of Neurology, Albert Einstein College of Medicine of Yeshiva University. “While these data show a positive result for most women treated for acute severe migraine, more research is needed to better understand the relationship between migraine, available treatments during pregnancy and birth outcomes.”
Researchers analyzed patient charts from July 2009 through January 2012. The average patient age was 29 years and gestational age was 27.5 weeks. Patients were mostly Hispanic (44.8%) or African American (37.9%). In addition to acetaminophen (79.3%) and IV metoclopramide (58.6%), patients were treated with a combination of both of those treatments (55.2%); oral or IV opiate (34.5%); acetaminophen, butalbital, and caffeine (24.1%); and IV magnesium sulfate (6.9%). In 10.3% of patients, insufficient pain relief led to treatment with peripheral nerve blocks.
In addition to Dr. Robbins, other researchers involved in the study are Tracy Grossman, M.D., M.S., resident, Obstetrics and Gynecology & Women’s Health, and Ashlesha Dayal, M.D., medical director, Labor and Delivery, associate professor, Obstetrics and Gynecology & Women's Health, Einstein.
“We always use caution when managing pregnant patients with headache. Several treatment options were captured in this study and we were pleased to take the first step in describing the array of treatments available, and to begin to document pre-term birth rates and compare them to the general population,” said Dr. Robbins. “Our comprehensive team of headache, obstetric and gynecology experts are committed to further exploration and have already doubled our patient population for the next analysis.”
About Montefiore Medical Center As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Recognized among the top hospitals nationally and regionally by U.S. News & World Report, Montefiore provides compassionate, patient- and family-centered care and educates the healthcare professionals of tomorrow. The Children's Hospital at Montefiore is consistently named in U.S. News' "America's Best Children's Hospitals," and is second among those in the New York metro area. With four hospitals, 1,491 beds and 90,000 annual admissions, Montefiore is an integrated health system seamlessly linked by advanced technology. State-of-the-art primary and specialty care is provided through a network of more than 130 locations across the region, including the largest school health program in the nation and a home health program. Montefiore's partnership with Einstein advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. The medical center derives its inspiration for excellence from its patients and community, and continues to be on the frontlines of developing innovative approaches to care. For more information please visit www.montefiore.org and www.montekids.org. Follow us on Twitter; like us on Facebook; view us on YouTube.
About Albert Einstein College of Medicine of Yeshiva UniversityAlbert Einstein College of Medicine of Yeshiva University is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2012-2013 academic year, Einstein is home to 742 M.D. students, 245 Ph.D. students, 116 students in the combined M.D./Ph.D. program, and 360 postdoctoral research fellows. The College of Medicine has more than 2,000 full-time faculty members located on the main campus and at its clinical affiliates. In 2012, Einstein received over $160 million in awards from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore Medical Center, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Through its extensive affiliation network involving Montefiore, Jacobi Medical Center –Einstein’s founding hospital, and five other hospital systems in the Bronx, Manhattan, Long Island and Brooklyn, Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States. For more information, please visit www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube. ###
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