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      Headaches during pregnancy in women with a prior history of menstrual headaches Translated title: Cefaléia durante a gestação em mulheres com história de cefaléia menstrual


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          OBJECTIVE: To evaluate the presence of menstrual headaches prior to pregnancy according to the International Headache Society (IHS) classification criteria, 2004, and also study the outcome (frequency and intensity) of these pre-existing headaches during the gestational trimesters. METHOD: This study involved 1,101 pregnant women (12 to 45 years old). A semi-structured questionnaire was used to interview the women during the first, second and third gestational trimesters as well as after delivery. All the interviews were conducted by one of the researchers by applying the IHS Classification (IHSC-2004). RESULTS: A 1,029 women out of the 1,101 women interviewed presented headaches prior to gestation, which made it possible to study headaches in 993 women during the gestational trimesters. Menstrually related headaches were presented by 360 of the 993 women. Migraine was reported by 332/360 women (92.22%) with menstrual headaches and 516/633 women (81.51%) without menstrual headaches, respectively, prior to gestation. The majority of the women with menstrual migraine presented a headache improvement or disappearance during gestation (62.22% during the first trimester; 74.17% during the second trimester; 77.78% during the third trimester). CONCLUSION: Most of the pregnant women with menstrual or non-menstrual headaches prior to gestation presented migraine, which either improved or disappeared during pregnancy. Women who suffered from non-menstrual headaches improved during pregnancy but not as much as women with menstrual headaches.

          Translated abstract

          OBJETIVO: Avaliar a presença de cefaléia relacionada ao ciclo menstrual, antes da gestação, classificá-las, segundo os critérios da Sociedade Internacional de Cefaleia (SIC) de 2004, e estudar o comportamento (freqüência e intensidade) dessas cefaléias pré-existentes à gestação durante os trimestres gestacionais. MÉTODO: Foram estudados 1101 mulheres grávidas (12 a 45 anos) entrevistadas através de questionário semi-estruturado durante o primeiro, o segundo e o terceiro trimestres gestacionais e imediatamente após o parto. Todas as entrevistas foram conduzidas por um dos autores, usando a classificação da SIC, 2004. RESULTADOS: De 1101 mulheres, 1029 apresentavam cefaléia antes da gestação, sendo possível estudar o comportamento das cefaléias durante os trimestres gestacionais em 993. Apresentaram cefaléia relacionada à menstruação 360/993 mulheres. Encontramos migrânea em, 332/360 (92,22%) mulheres com cefaléia menstrual e em 516/633 (81,51%) mulheres com cefaléia não menstrual antes da gestação. A maioria das mulheres com migrânea menstrual apresentou melhora da cefaléia durante a gestação (62,22% no primeiro trimestre; 74,17% no segundo trimestre; 77.78% no terceiro trimestre). CONCLUSÃO: A maioria das mulheres grávidas, com cefaléia tanto menstrual quanto não menstrual, antes da gestação, apresentou migrânea, sendo que a mesma melhora ou desaparece durante a gestação. Mulheres com cefaléia não menstrual antes da gestação melhoram em proporção menor do que aquelas com cefaléia menstrual.

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          Most cited references28

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          The International Classification of Headache Disorders: 2nd edition.

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            Migraine and reporoductive hormones throughout the menstrual cycle.

            In a clinical survey the relation between migraine and menstruation was studied in 142 otherwise healthy women. In 24, onset of migraine coincided with the year of menarch. Of the 138 patients in whom onset of migraine predated the menopause, there were only 13 in whom attacks occurred regularly, and only, just before or during menstruation; in a further 11 attacks occurred regularly in relation to menstruation and at other times. Those with menstrually related migraine were more likely to have onset of migraine at menarche, to have associated weight gain and breast discomfort as part of a periodic syndrome, and to show improvement during pregnancy. There appeared no clear pattern of change at the menopause. In a study of reproductive hormones, blood was collected daily throughout a menstrual cycle from each of 8 women with menstrually related migraine, 6 with menstrually non-related migraine, and 8 healthy headache-free controls. Plasma levels of follicle-stimulating hormone (F.S.H.), luteinising hormone (L.H.), prolactin, oestrogen, and progesterone were measured in all. Plasma-testosterone was measured in 8 migraine patients. Mean plasma oestrogen and progesterone levels were significantly higher in migraine patients than controls for most of the menstrual cycle, with the most striking differences found in the late luteal phase for progesterone. No significant difference was found between the menstrually related and non-related patients for these or the other hormones measured. Mean plasma-prolactin levels were lower in migraine subjects than controls, but the difference was not significant. Mean plasma F.S.H. and L.H. levels were similar in both migraine and control groups. Plasma-testosterone levels were within the range for normal in the 8 migraine patients studied. No specific hormone changes were associated with the occurrence of a migraine attack, nor did rising or falling levels, or greater increments of change over given cycle phases, appear important in provoking attacks.
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              A study of migraine in pregnancy.


                Author and article information

                Role: ND
                Role: ND
                Role: ND
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                December 2005
                : 63
                : 4
                : 934-940
                [1 ] Universidade Estadual de Campinas Brazil
                [2 ] Catanduva Medical School Brazil
                [3 ] Universidade Estadual de Campinas Brazil



                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en

                Neurosciences,Clinical Psychology & Psychiatry


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