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Headache in Pregnancy

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101. New measures to avoid valproate exposure in pregnancy endorsed

the conditions of a new pregnancy prevention programme are met. The programme is designed to ensure that patients are made fully aware of the risks and the need to avoid becoming pregnant. A visual warning of the pregnancy risks (in the form of boxed text with other possible elements such as a warning symbol) must also be placed on the packaging of the medicines and warnings be included on patient cards attached to the box and supplied with the medicine each time it is dispensed. The agreed with EMA's (...) : an assessment of each patient's potential for becoming pregnant, pregnancy tests before starting and during treatment as needed, counselling about the risks of valproate treatment and the need for effective contraception throughout treatment, a review of ongoing treatment by a specialist at least annually, introduction of a new risk acknowledgement form that patients and prescribers will go through at each such annual review to confirm that appropriate advice has been given and understood. As before

2018 European Medicines Agency - EPARs

102. Headache-Related Neuroimaging

Neuroimaging Headache-Related Neuroimaging Aka: Headache-Related Neuroimaging , Neuroimaging in Headache II. Indications s III. Protocol: Imaging selection Immunocompromised with and without contrast suspected in age >60 years with and without contrast Requires starting s and obtaining temporal artery biopsy Suspected or without contrast Start antibiotics and obtain Pregnancy and severe (preferred) or Suspected carotid dissection with severe unilateral with and without contrast and MRA of the head and neck (...) Headache-Related Neuroimaging Headache-Related Neuroimaging Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Headache-Related

2018 FP Notebook

103. Headache Red Flag

Headache Red Flag Headache Red Flag Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Headache Red Flag Headache Red Flag Aka: Headache (...) Asymmetric motor function Abnormal Onset recently or suddenly Onset after age 40 years Prior that is different or progressive Different location is less useful as predictor of serious cause Pain response to standard therapy is not predictive of serious cause References Dodick (2003) Adv Stud Med S550-5 VI. References Edlow and Weinstock (2013) EM:Rap 13(12): 7-8 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Headache Red Flag." Click

2018 FP Notebook

104. Migraine Headache Prophylaxis

Migraine Headache Prophylaxis Migraine Headache Prophylaxis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Migraine Headache (...) Prophylaxis Migraine Headache Prophylaxis Aka: Migraine Headache Prophylaxis , Migraine Prophylaxis From Related Chapters II. Epidemiology Of the 38% of episodic patients in whom prophylaxis is indicated, less than half are taking prophylaxis III. Indications: Frequent Migraine Headaches frequency s per month: 4 or more OR days per month: 8 or more Consider in any patient desiring Migraine Prophylaxis to reduce frequency duration Prolonged s >2 days with response to Debilitating despite acute abortive

2018 FP Notebook

105. Bacterial vaginosis in pregnancy and risk of spontaneous preterm delivery

The objective of this guideline is to evaluate bacterial vaginosis in pregnancy concerning • Different treatments for prevention of preterm delivery. • Screening of pregnant women with low as well as high risk of sPTD. • Stratification into gestational ages below and above 16 weeks. • Diagnostic methods. Key words Bacterial vaginosis, vaginal pH, pH-glove, vaginal discharge, Nugent score, Amsel score, Gardnerella vaginalis, Mobiluncus species, preterm delivery, preterm birth, GRADE, clindamycin (...) , clindamycin might be used for treatment of symp- toms). • This recommendation addresses both treatment with metronidazole and clindamycin. • This recommendation addresses all gestational ages of pregnancy. Treatment with probiotics ??: We suggest against treatment of BV-positive pregnant women with probiotics in order reducing the risk of sPTD. • This recommendation addresses both women at low and high risk of sPTD. • This recommendation addresses asymptomatic as well as symptomatic women

2019 Nordic Federation of Societies of Obstetrics and Gynecology

106. Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic Full Text available with Trip Pro

on OUD in particular; to draft preliminary recommendations regarding screening, pain management, and medication-assisted therapy (MAT) for OUD during pregnancy; and to delineate research gaps. Epidemiology of opioid use in pregnancy Epidemiologic evidence that was presented at the workshop demonstrated that rates of substance use in pregnancy have increased significantly in the past decade and that rates of OUD in pregnant and postpartum women have increased in parallel: • One study reported (...) on epidemiology, prenatal screening, pain management, and treatment modalities of OUD in pregnancy, workshop participants were assigned to 1 of 3 breakout groups to discuss the following key issues in greater depth and to make preliminary recommendations: (1) screening and testing for substance use disorder, including OUD, in pregnancy; (2) pain management during the antepartum, intrapartum, and postpartum periods; and (3) management modalities for pregnant women with OUD. The following key findings emerged

2019 Society for Maternal-Fetal Medicine

107. UK guidelines on the management of iron deficiency in pregnancy Full Text available with Trip Pro

is required for fetal growth and development (Scholl, ), as well as for increased maternal erythropoiesis (Bothwell, ; Fisher & Nemeth, ). The current Hb thresholds defining anaemia in pregnancy are based on historical normal values derived from non‐pregnant populations, which are not clearly linked to clinical outcomes and there is ongoing debate as to the applicability of these values (Pasricha et al , ). The WHO is reviewing the evidence relating to the Hb below which anaemia should be defined (WHO (...) period are recognised as a critical period where there is rapid brain development, high neural plasticity and high nutritional requirement (Gluckman & Hanson, ; Georgieff et al , ). Animal studies show maternal iron deficiency late in pregnancy is associated with neurodevelopmental impairment. Observational studies in pregnant women have found that iron deficiency anaemia late in pregnancy is associated with premature birth and low Apgar score (<5 at 1 min) (Lone et al , ), and impaired motor

2019 British Committee for Standards in Haematology

108. Syphilis in pregnancy

, and cytokines, leading to an acute inflammatory response 24 · More common during treatment for infectious syphilis 24 due to high bacterial burden 31 · Case studies report JHR occurs in up to 44% of pregnant women treated for syphilis 44,45 · Concerns about JHR relevant only to the first dose of treatment Symptoms · Onset within 2–12 hours post treatment and lasts several hours 44 · Usually self-limiting 44,46 resolving by 24 hours after treatment 24 · Fever, headaches, rigors, joint pain chills, malaise (...) reduction · Early screening of all pregnant women, and identification of high risk pregnancies and babies can prevent adverse perinatal outcomes 15,16 Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 9 of 31 1.4 Notifiable disease Table 3. Disease notification Aspect Consideration Context · Syphilis is a controlled notifiable disease in Queensland as per the Public Health Act (2005) 19 · Routine reporting is the cornerstone of syphilis

2019 Queensland Health

109. A Cost Effective Treatment for Headache in Pregnancy When Acetaminophen Alone is Ineffective.

A Cost Effective Treatment for Headache in Pregnancy When Acetaminophen Alone is Ineffective. A Cost Effective Treatment for Headache in Pregnancy When Acetaminophen Alone is Ineffective. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. A Cost Effective Treatment for Headache in Pregnancy When Acetaminophen Alone is Ineffective. (MAD) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02295280 Recruitment Status : Completed First Posted : November 20, 2014 Results First Posted : April 2, 2018 Last

2014 Clinical Trials

110. CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy

(eg, shortness of breath, mild chest pain, edema) can be seen in normal pregnancies, these entities are especially difficult to diagnose. Chronic hypertension is defined as hypertension (>140 mm Hg systolic or >90 mm Hg diastolic) diagnosed prior to pregnancy or before 20 weeks’ gestation. The key question in the ER is: Does that patient have any end organ dysfunction? (head, eyes, heart, lungs, liver, kidney, bone marrow) Medical treatment of uncomplicated chronic hypertension in pregnancy (...) are all more common than myocardial ischemia during pregnancy and should be considered in the differential diagnosis of the pregnant patient who presents with chest pain. [3] How is maternal Hepatitis B managed in the peripartum period? What treatments are indicated for the fetus? Perinatal transmission is approximately 10% to 20% in women seropositive for HBV surface antigen (HBsAg) alone but approaches 90% in mothers who are seropositive for HBsAg and HBV envelope antigen (HBeAg); it is also more

2018 CandiEM

111. CRACKCast E177 – Acute Complications of Pregnancy

) Serum creatinine >97.2 micromol/L or doubling of the creatinine concentration in the absence of other renal disease Liver transaminases at least twice the upper limit of the normal concentrations Pulmonary edema Cerebral or visual symptoms (eg, new-onset and persistent headaches not responding to usual doses of analgesics* ; blurred vision, flashing lights or sparks, scotomata) 6) Why are pregnant patients at increased risk of VTE? They have the trifecta of virchow! Pregnancy is a hypercoagulable (...) check out EM Cases Rapid Reviews Videos on Shownotes – Key Points You know a chapter is gargantuan when the summary points are two pages long….so here we go. We’ll cover the key, key concepts Ectopic pregnancy Bleeding in late pregnancy Hypertension in pregnancy AF Embolism Rh immunization Abd pain in pregnancy N/V in pregnancy VTE in pregnancy Vaginal and UTIs Thyroid disease Ectopic Pregnancy An ectopic pregnancy can masquerade as a threatened miscarriage in the early stages of pregnancy

2018 CandiEM

112. Pre-Operative Pregabalin for Post-Operative Pain in Head and Neck Cancer Surgery

Pre-Operative Pregabalin for Post-Operative Pain in Head and Neck Cancer Surgery Pre-Operative Pregabalin for Post-Operative Pain in Head and Neck Cancer Surgery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding (...) more. Pre-Operative Pregabalin for Post-Operative Pain in Head and Neck Cancer Surgery The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03714867 Recruitment Status : Enrolling by invitation First Posted : October 22, 2018 Last Update Posted : January 7, 2019 Sponsor: Augusta University Information

2018 Clinical Trials

113. Gabapentin, Methadone, and Oxycodone With or Without Venlafaxine Hydrochloride in Managing Pain in Participants With Stage II-IV Squamous Cell Head and Neck Cancer Undergoing Chemoradiation Therapy

Gabapentin, Methadone, and Oxycodone With or Without Venlafaxine Hydrochloride in Managing Pain in Participants With Stage II-IV Squamous Cell Head and Neck Cancer Undergoing Chemoradiation Therapy Gabapentin, Methadone, and Oxycodone With or Without Venlafaxine Hydrochloride in Managing Pain in Participants With Stage II-IV Squamous Cell Head and Neck Cancer Undergoing Chemoradiation Therapy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer (...) to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Gabapentin, Methadone, and Oxycodone With or Without Venlafaxine Hydrochloride in Managing Pain in Participants With Stage II-IV Squamous Cell Head and Neck Cancer Undergoing Chemoradiation Therapy The safety and scientific validity of this study is the responsibility

2018 Clinical Trials

114. Efficacy of Fluoroscopic Guided Atlantoaxial Joint Injection on Head and Neck Pain and Sleep Quality in RA Patients

inflammation and failure of resolution after 2 weeks systemic steroid administration Exclusion criteria Coagulopathy, allergy to contrast material, pregnancy Interventional group (AS) group, received intra-articular steroid injection for atlantoaxial joint. , in addition to methotrexate and chloroquine 400 mg per day. Condition or disease Intervention/treatment Phase Pain, Head Sleep Disturbance Drug: Steroids Early Phase 1 Detailed Description: Efficacy of intra-articular steroid injection for inflamed (...) Efficacy of Fluoroscopic Guided Atlantoaxial Joint Injection on Head and Neck Pain and Sleep Quality in RA Patients Efficacy of Fluoroscopic Guided Atlantoaxial Joint Injection on Head and Neck Pain and Sleep Quality in RA Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2018 Clinical Trials

115. Quality measures in high-risk pregnancies: Executive summary of a cooperative workshop of SMFM, NICHD, and ACOG Full Text available with Trip Pro

trials: re: prevention in pregnancy. Unclear International population- based cohort studies demonstrate improved maternal outcomes (decreased mortality rate). Yes Current infrastructure for risk assessment and monitoring has been implemented widely in hospitals for nonpregnant medical and surgical populations. Yes All pregnant women should undergo venous thromboembolism risk assessment and receive treatment if at increased risk; recommend tracking of prophylaxis rates, harms (wound infection, heparin (...) intensive care unit admissions. Yes Sepsis bundle associated with decreased mortality rates. Yes Early recognition and treatment associated with decreased mortality rate. Yes But need modi?ed scoring systems to identify pregnant women at increased risk. Yes Also recommend hospital-based internal quality review for initiation of management protocol andin-person provider evaluationin 1 previous pregnancy and who received outpatient daily low-dose aspirin prophylaxis before delivery No. of women who

2017 Society for Maternal-Fetal Medicine

116. Guideline Supplement: Early pregnancy loss

printed copies after use Page 5 of 16 Queensland Clinical Guideline Supplement: Early pregnancy loss 2.4.1 Keywords The following list of keywords was used in combination in the basic search strategy. Other keywords may have been used for specific aspects of the guideline. Key word/phrase Synonyms/Subject heading/Mesh term Early pregnancy loss “pregnancy loss” OR miscarriage OR ectopic OR “ectopic pregnancy” OR “threatened abortion” OR “threatened miscarriage” OR “missed abortion” OR “missed (...) . Table 6. Summary recommendations Recommendation Grading of evidence 1. Offer women experiencing early pregnancy loss, all options for care that are clinically appropriate to their individual circumstances Consensus 2. Perform a serum pregnancy test on all women of reproductive age presenting with a history of pain (abdominal, shoulder tip) and/or, PV bleeding Consensus 3. Register all women experiencing gestational trophoblastic disease with the Queensland Trophoblast Centre Consensus 4. Recommend

2017 Queensland Health

117. Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

one side effect, the most common of which was a headache or dizziness followed by nausea and vomiting. There was also no difference in the rate of serious side effects, which occurred in 1.6% of the aspirin group and 3.2% of the placebo group. What does current guidance say on this issue? 2011 NICE guidelines on hypertension in pregnancy recommend that women at high risk of pre-eclampsia take 75mg of aspirin daily from 12 weeks until the birth of the baby. High-risk factors are high blood pressure (...) for gestational age, preterm delivery (without pre-eclampsia), or pre-eclampsia at term (≥37 weeks). A quarter of women in both groups reported at least one side effect, the most common of which was a headache or dizziness followed by nausea and vomiting. There was also no difference in the rate of serious side effects, which occurred in 1.6% of the aspirin group and 3.2% of the placebo group. What does current guidance say on this issue? 2011 NICE guidelines on hypertension in pregnancy recommend that women

2019 NIHR Dissemination Centre

118. Treating subclinical thyroid dysfunction in pregnancy probably has no benefit

Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Discover Portal Discover Portal Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Published on 8 August 2017 doi: Testing for and then treating pregnant women with mild or “subclinical” underactive thyroid did not improve pregnancy outcomes, newborn baby outcomes, or the child’s IQ at three to five years (...) that help to regulate the body’s metabolism. Around 15 in every 1,000 women in the UK have an underactive thyroid though fewer women in pregnancy have the condition, about four in every 1,000 women. People with definite (clinical) low thyroid hormones can feel tired or depressed, gain weight and experience muscle aches, it can also lead to high cholesterol. In pregnancy there can also be harms to the unborn child including failure to develop normally and reduced intelligence. Therefore, clinical

2019 NIHR Dissemination Centre

119. Pregnancy, Birth, Neonatal, and Postnatal Neurological Outcomes After Pregnancy With Migraine. (Abstract)

seizures (aRR: 1.27 [95% CI: 1.03-1.57), but not of death (aRR: 0.67 [95% CI: 0.43-1.04]) and cerebral palsy (aRR: 1.00 [95% CI: 0.51-1.94]).Women with migraine and their offspring have greater risks of several adverse pregnancy outcomes than women without migraine.© 2019 American Headache Society. (...) Pregnancy, Birth, Neonatal, and Postnatal Neurological Outcomes After Pregnancy With Migraine. Prevalence of migraine is high during the reproductive age. Although migraine often improves during pregnancy, the risk of adverse pregnancy, birth, neonatal, and neurological outcomes in mother and offspring remains poorly understood.To investigate the associations between maternal migraine and risks of adverse pregnancy outcomes in the mother, and birth, neonatal and postnatal outcomes

2019 Headache

120. Headache in Pregnancy

Headache in Pregnancy Headache in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Headache in Pregnancy Headache (...) in Pregnancy Aka: Headache in Pregnancy , Migraine in Pregnancy , Antepartum Headache , Postpartum Headache From Related Chapters II. Types: Primary Headaches Improves with pregnancy in up to 70% of patients Some cases of first occur in first trimester Associated with aura III. Differential Diagnosis: Secondary Headaches in Antepartum Period See for other causes See s ( ) Consider after 20 weeks IV. Differential Diagnosis: Secondary Headaches in Postpartum Period (Postpartum Headache) See for other causes

2015 FP Notebook

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