Headaches which women experience during pregnancy are not always harmless. Therefore, although most headaches in pregnancy and the postnatal period are benign, healthcare professionals must be alert to the rarer and more severe causes of headaches reported Wiley. Healthcare professionals should be alert to manage the care of women suffering from headaches appropriately.
There are recognized to be 85 different types of headaches. About 90 percent of headaches experienced in pregnancy are migraine or tension-type headaches. It has however been pointed out that pregnancy can lead to an increased risk of certain secondary headaches. A review has found that most headaches in pregnancy are benign. However, in some cases they can be more serious.
Migraine is a relatively common form of headache which is more common in women. The highest prevalence of migraine rates occur during the childbearing years. It has been observed that pregnancy leads to a lowering in the frequency and severity of attacks of migraines without an aura, or a common migraine.
However, it has been found that women who do experience migraines have a greater than two-fold increased risk of pre-eclampsia than those women who do not. Women should therefore consult a healthcare professional if their headache is not the same as their usual migraine.
Idiopathic intracranial hypertension is also a condition which is associated with a headache in pregnancy. This is a rare condition which is more prevalent in obese women of childbearing age. Sometimes this condition presents for the first time in pregnancy and pre-existing disease generally worsens in pregnancy. Idiopathic intracranial hypertension can be fatal if it is not treated very quickly as a medical emergency.
Pregnancy has also been recognized as a risk factor for cerebral venous thrombosis (CVT), which is the presence of a blood clot in the dural venous sinuses. The risk for CVT is increased by caesarean section, systematic infection, vomiting and anaemia. Headache is the most frequently occurring symptom in CVT. It is often the first symptom which is reported by patients.
This review has been published in the journal The Obstetrician & Gynaecologist. It is highlighted that headaches in pregnancy and the postnatal period are common and they are generally benign. However, they can herald an intracranial catastrophe. Therefore the ability to assess a headache in pregnancy is an essential skill for obstetricians and general practitioners.
