HealthDay News — Peripheral nerve blocks may be a safe treatment option for pregnant women with migraines that don’t respond to medications, according to research published online in Obstetrics & Gynecology.

Shravya Govindappagari, MD, from the Albert Einstein College of Medicine in Bronx, N.Y., and colleagues retrospectively reviewed the charts of all pregnant patients (mean age, 28 years; mean gestational age, 23.5 weeks) treated with peripheral nerve blocks for migraine over a five-year period.

The researchers found that peripheral nerve blocks were performed 27 times in 13 pregnant women either in a single (six women) or multiple (seven women) injection series. More than one-third (38.5%) of women had chronic migraine. Peripheral nerve blocks were used for status migrainosus (51.8%) or short-term prophylaxis of frequent headache attacks (48.1%). 


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Oral medications failed for all patients and intravenous medications failed for most before peripheral nerve blocks were performed. For those with status migrainosus, average pain reduction was significant immediately post-procedure (P < 0.001) and 24 hours post-procedure (P = 0.007). There were no serious immediate, procedurally-related adverse events; however, two patients who had no acute pain reduction ultimately developed preeclampsia and had postpartum headache resolution.

“Peripheral nerve blocks for treatment-refractory migraine may be an effective therapeutic option in pregnancy,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Reference

  1. Govindappagari S et al. Obstet Gynecol. 2014; doi:10.1097/AOG.0000000000000555.