Innovating Headache Care for Pregnant Patients: Three-year Experience from the University of Pennsylvania’s Fast-track Pregnancy Headache Clinic
Seniha Ozudogru1
1University of Pennsylvania
Objective:
To describe patient characteristics and evaluate outcomes of two commonly used preventive treatments, magnesium oxide and peripheral nerve blocks, from the University of Pennsylvania’s Fast-Track Pregnancy Headache Clinic.  
Background:
Migraine is a common disorder that disproportionately affects women of childbearing age. Data regarding efficacy of commonly recommended preventative treatment options during pregnancy are limited. The fast-track pregnancy headache clinic was established to provide timely evaluation and evidence-based management for pregnant patients with headache.  
Design/Methods:
Since December 2022, women’s health providers have had accessed to expedited headache subspeciality consultations. As of September 2025, 268 patients have been referred and 102 evaluated.  
Results:

Demographic information includes: 

Age ranges: <34 years N=77, 35-39 years N=20, 40-44 years N=5  

  • Gender identity: cis woman 91; non-binary 1; no information available=10 

  • Ethnicity: African American 46; Asian 5; Caucasian 45; Hispanic 1; Other 5 

Diagnoses included:  

  • Episodic migraine without aura 47 

  • Episodic migraine with aura 20 

  • Chronic migraine without aura 15 

  • Chronic migraine with aura 8 

  • -Other (TTH, cTTH, IIH, cervicogenic headache, etc) 12 

Follow up was available for 63 patients.  Among 25 patients who treatment with magnesium oxide 400 – 500 mg daily, 24 (96%) reported improvement in migraine frequency and/or severity. Thirty patients received peripheral nerve blocks with lidocaine for prevention; 17 (56.7%) reported effectiveness in reducing frequency and severity of migraine attacks, 3 (10%) reported no benefit, and 10 (33.3%) were lost to follow up.  

Conclusions:
Episodic Migraine without aura was the most common diagnosis among pregnant patients evaluated in the fast-track pregnant headache clinic. Magnesium oxide and peripheral nerve blocks with lidocaine were effective options for the majority of patients. These findings underscore the importance of prompt evaluation and expedited headache specialist consultation model to ensure timely, safe and effective headache care during pregnancy.  
10.1212/WNL.0000000000216463
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