Medication Use and Pain Management in Pregnancy: A Critical Review

  title={Medication Use and Pain Management in Pregnancy: A Critical Review},
  author={Eleanor Black and Kok Eng Khor and Debra S Kennedy and Anuntapon Chutatape and Swapnil Sharma and Thierry Vancaillie and Apo Demirkol},
  journal={Pain Practice},
Pain during pregnancy is common, and its management is complex. Certain analgesics may increase the risk for adverse fetal and pregnancy outcomes, while poorly managed pain can result in adverse maternal outcomes such as depression and hypertension. Guidelines to assist clinicians in assessing risks and benefits of exposure to analgesics for the mother and unborn infant are lacking, necessitating evidence‐based recommendations for managing pain in pregnancy. 

Safe use of paracetamol and high-dose NSAID analgesia in dentistry during the COVID-19 pandemic

With dental services currently altered, dentists are being asked to provide advice, analgesia and antibiotics in situations where they would normally be offering operative care. Dentists are familiar

Assessing the Knowledge of Analgesic Drugs Utilization during Pregnancy among Women in Saudi Arabia: A Cross-Sectional Study

Pregnant women in Saudi Arabia have a good perception of the safest and most effective analgesic drug during pregnancy, but they have poor knowledge about analgesics’ side effects.

Paracetamol use during pregnancy — a call for precautionary action

Pregnant women should be cautioned at the beginning of pregnancy to forego APAP unless its use is medically indicated; consult with a physician or pharmacist if they are uncertain whether use is indicated and before using on a long-term basis; and minimize exposure by using the lowest effective dose for the shortest possible time.

Epidemiology and Treatment of Menstrual Migraine and Migraine During Pregnancy and Lactation: A Narrative Review

  • R. Burch
  • Psychology, Medicine
  • 2019
The evidence for sex differences in the expression of migraine across the reproductive epoch is described; the epidemiology of migraine during pregnancy, lactation, and menses is reviewed; and the available evidence for safety and efficacy of acute treatments during pregnancy and lactation and for menstrual migraine is summarized.

[Challenge abstinence-a case report and overview on therapy of alcohol dependence during pregnancy].

  • S. ListabarthD. König A. Gmeiner
  • Medicine
    Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater
  • 2020
In the portrayed case-report, a pregnant patient received psychopharmacological treatment with Sertraline, Quetiapine and Ondansetron, and under this established pharmacological therapy, the patient achieved abstinence for the remainder of the pregnancy.

Increased risk of preeclampsia after use of paracetamol during pregnancy – causal or coincidence?

The use of paracetamol in the third trimester of pregnancy was associated with preeclampsia and this observation indicates that association between par acetamol use and pree clampsia is probably due to reverse causation, i.e. women with preeClampsia experience more headaches due to preeclamping symptoms since this association was not detected with the use ofParacetamols in earlier stages of pregnancy.

Ensuring healthy and safe birth: putting women at the center of antenatal care

  • _ __
  • Medicine
    Asian Biomedicine
  • 2020
The purpose of ANC is to maximize a good outcome of delivery, i.e., a healthy baby and no complications in the mother, so it is necessary to correctly estimate gestational age and to early identify mothers with the potential risk of morbidity and mortality.

Enhanced Recovery After Surgery: Cesarean Delivery

The ERAS CD knowledge transfer and implementation will require multidisciplinary team coordination in the preoperative, intraoperative, and postoperative phases and the development of a formalized ERAS® guideline for ERASCD.

Perinatal use of triptans and other drugs for migraine—A nationwide drug utilization study

Triptan discontinuation during and in the year after pregnancy was common, and women using preventive migraine treatment were most commonly triptan continuers and re-initiators after pregnancy.

Safety profile of erenumab, galcanezumab and fremanezumab in pregnancy and lactation: Analysis of the WHO pharmacovigilance database

No specific maternal toxicities, patterns of major birth defects, or increased reporting of spontaneous abortion were found, and because of the relatively limited number of adverse drug reactions reported and the lack of long-term safety data, continuous surveillance is required in pregnant and lactating women exposed to these drugs.



Management of Non-Obstetric Pain during Pregnancy: A Review

This review aims to understand the pathophysiology and various cause of non-obstetric pain during pregnancy and explore the available evidence for prevention and management.

Management of Nonobstetric Pain During Pregnancy and Lactation

The potential for fetal toxicity or teratogenic effects of medications often used to treat pain syndromes, as well as the safety of these medications in the breast-feeding mother are discussed.

Safe management of chronic pain in pregnancy in an era of opioid misuse and abuse.

Development of a pain management protocol for the counsel and care of pregnant women with pain is necessary.

Manage chronic pain during pregnancy with selected analgesics

Pregnant women with chronic pain require sustained pain management during the course of their pregnancy, and the use of some analgesics and adjuvant analgesics are preferably avoided during some or all stages of pregnancy.

Ongoing Pharmacological Management of Chronic Pain in Pregnancy

It is prudent to avoid ASA and NSAIDs towards the end of the pregnancy, while acetaminophen is an acceptable option all through pregnancy, if continued use of opioids is necessary, and the associated risks are low.

Treatment of Pain in Pregnancy

Experience in women seeking recovery from opioids and their newborns illustrates that opioids are an effective and safe pharmacological option for the treatment of pain during pregnancy.

Analgesics and pain relief in pregnancy and breastfeeding

Women should be reassured that pain can be treated during pregnancy and lactation and that they will be able to tell when they are in pain and how to treat it.

Evaluating the Use of Ketamine for Pain Control With Sickle Cell Crisis in Pregnancy: A Report of 2 Cases.

Ketamine may be considered as an adjunct analgesic in pregnant patients with sickle cell pain, although prospective clinical data are needed to fully assess its efficacy.

Antidepressant use in pregnancy: a critical review focused on risks and controversies

This study reviews the literature on risks of exposure to antidepressants during pregnancy, discusses the strengths and weaknesses of the different study designs used to evaluate those risks, and provides clinical recommendations.

Chronic pain during pregnancy: a review of the literature

The management of chronic pain associated with pregnancy is understudied and 7 guidelines for chronic pain management during and after pregnancy are recommended.