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Secondary Headaches During Pregnancy: When to Worry
Claire H Sandoe1, Christine Lay2
1Women's College Hospital Centre for Headache, Division of Neurology, University of Toronto, 76 Grenville St., Toronto, Ontario, M5S 1B2, Canada.
Current Neurology and Neuroscience Reports
|April 24, 2019
Summary
Headaches during pregnancy can signal serious conditions. Recognizing red flags like high blood pressure and abnormal lab tests is crucial for timely diagnosis and management of secondary headaches.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Internal Medicine
Background:
- Headaches are common in pregnancy, causing patient and provider concern.
- Physiological changes increase risks for primary and secondary headache disorders.
Purpose of the Study:
- Review recent research on distinguishing worrisome from non-worrisome headaches in pregnancy.
- Identify key indicators for secondary causes of headaches during gestation.
Main Methods:
- Literature review of recent research on pregnancy headaches.
- Analysis of prevalence and common causes of secondary headaches in pregnant individuals.
- Identification and categorization of red flag symptoms and signs.
Main Results:
- Secondary headache causes are prevalent (25-42.4%) in pregnant women seeking medical care.
- Common secondary causes include hypertensive disorders, vascular issues, infections, and homeostatic disturbances.
- Specific red flags include new-onset severe headaches, systemic symptoms (elevated BP, fever), abnormal labs (thrombocytopenia, proteinuria), and lack of headache history. The PREGNANT HA mnemonic aids recall.
Conclusions:
- Secondary headaches are common in pregnant women and require careful evaluation.
- Recognizing specific red flags is essential for differentiating serious from benign headache presentations.
- Enhanced patient and provider education can improve the identification of secondary headaches during pregnancy.
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