Headache and pregnancy: a systematic review.

Area of Science:

• Neurology
• Obstetrics & Gynecology
• Pharmacology

Background:

• Headache during pregnancy encompasses primary and secondary types, with secondary headaches potentially indicating life-threatening conditions.
• Common secondary headaches include stroke, cerebral venous thrombosis, subarachnoid hemorrhage, and preeclampsia.
• Migraine is a known risk factor for pregnancy complications, particularly vascular events.

Purpose of the Study:

• To systematically review current data on headache in pregnancy.
• To analyze clinical phenotypes, diagnostic approaches, and treatment strategies.
• To evaluate the effects of headache medications on the fetus and infant.

Main Methods:

• Systematic literature review of existing data on headache and pregnancy.
• Analysis of clinical presentations, diagnostic tools, and therapeutic interventions.
• Assessment of medication safety during pregnancy and breastfeeding.

Main Results:

• Early diagnosis is critical, emphasizing the identification of "red flag symptoms" for serious secondary headaches.
• Diagnostic tools include EEG, ultrasound, MRI, MR angiography, ophthalmoscopy, and lumbar puncture.
• Non-pharmacological treatments are preferred for primary headaches; medication use requires careful risk-benefit assessment.

Conclusions:

• Headache in pregnancy necessitates prompt and accurate diagnosis to differentiate benign from dangerous causes.
• Non-pharmacological interventions should be the first line of treatment for primary headaches.
• Medication decisions during pregnancy and breastfeeding must balance maternal needs with fetal/infant safety.