Manage Migraine during pregnancy

reassure the patient in most of cases, the frequency of migraine attack improve during pregnancy but if the headache occured and become intoelarble taking her regimen considered be safe under specialist advice with better to use Paracetamol instead of NSAIDs
:heart:Triptans generally not recommended in pregnancy and in breast feeding but its use in pregnancy with frequent migraine attacks considered (SAFE) after discussing pros and cons and also if she is breast feeding we counsel her to keep dose 12 hours from breast feeding.
:heart:we should emphasize about the importance of Non pharmacological intervetions which include (Adequate hydration, good sleep pattern, avoid coffe, Any stressors)
:heart:Preventive treatment during pregnancy according to guidelines by NICE, it is considered safe to use Low Dose AMITRYPTALINE (Dose 40mg/d) as FIRST option or LOW dose Propranolol (10-20mg/d).
:heart:For pregnant woman on propranolol, it is recommended to stop the dose 2 days prior delivery and watch for Neonatal bradycardia and Hypoglycemia.