Enxaqueca na gravidez: uma revisão integrativa

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Autores

DOI:

https://doi.org/10.48208/HeadacheMed.2025.35

Palavras-chave:

Enxaqueca, Gravidez, Pós-parto, Amamentação, Complicações fetais

Resumo

Contexto

A enxaqueca é a cefaleia primária mais prevalente na gravidez, com implicações clínicas únicas que exigem abordagens de manejo especializadas.

Objetivo

Fornecer uma revisão abrangente da fisiopatologia, curso clínico, diagnóstico e manejo da enxaqueca durante a gravidez, o pós-parto e a lactação.

Métodos

Busca seletiva de literatura nas bases de dados PubMed, Scopus e Web of Science, complementada por ferramentas de inteligência artificial (Elicit e Consensus) para garantir a cobertura abrangente de evidências emergentes, de 2003 a 2025.

Principais Resultados

As flutuações hormonais impulsionam a fisiopatologia da enxaqueca, sendo que a estabilidade hormonal da gravidez geralmente melhora os sintomas em 60-70% das mulheres com enxaqueca sem aura durante o segundo e terceiro trimestres. No entanto, a enxaqueca com aura apresenta melhora menos previsível e podem ocorrer novos ataques. A enxaqueca materna, particularmente com aura, está associada a distúrbios hipertensivos, parto prematuro, parto cesáreo, restrição do crescimento fetal e aumento do risco de acidente vascular cerebral isquêmico. Comorbidades psiquiátricas, incluindo depressão e ansiedade, são frequentes e associadas a piores desfechos.

Manejo

Intervenções não farmacológicas constituem a base do tratamento. Quando a terapia farmacológica é necessária, o paracetamol é a primeira opção, os AINEs podem ser usados ​​apenas no segundo trimestre e o sumatriptano é a opção mais segura entre os triptanos. O tratamento preventivo deve ser reservado para casos graves e refratários, com magnésio, propranolol e amitriptilina como opções baseadas em evidências.

Conclusão

A enxaqueca durante a gravidez e o pós-parto requer uma abordagem multidisciplinar que priorize estratégias farmacológicas seguras, monitoramento individualizado e otimização do estilo de vida para garantir os melhores resultados maternos e fetais.

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Publicado

2026-01-01

Como Citar

1.
María Karina, Schubaroff P, Cid-Jeffs ML, Mercedes-Robles A, Martinez-Mayorga AP, Rodriguez-Leyva I, et al. Enxaqueca na gravidez: uma revisão integrativa. Headache Med [Internet]. 1º de janeiro de 2026 [citado 7º de janeiro de 2026];16(4):209-23. Disponível em: https://www.headachemedicine.com.br/index.php/hm/article/view/1373

Edição

v. 16 n. 4 (2025)

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Copyright (c) 2025 María Karina Vélez-Jiménez, Pablo Schubaroff, Maria Loreto Cid-Jeffs, Ana Mercedes-Robles, Adriana Patricia Martinez-Mayorga, Ildefonso Rodriguez-Leyva, Daniel San-Juan, Javier Andrés Galnares-Olalde, Miguel Angel Morales-Morales, Kevin Espejo-Campos (Author)

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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.