The vast majority of headaches experienced during pregnancy and the postnatal period are benign, with approximately 90% of occurrences of head pain during these phases representing migraine or tension-type headaches. According to a new review published in The Obstetrician & Gynaecologist, however, pregnancy has also been linked to an increased risk of developing secondary headaches related to a number of underlying health conditions. This being the case, it is advised that healthcare professionals remain aware of rarer and more severe headache causes when evaluating pregnant patients.
The review authors examined the 2006-2008 report on Confidential Enquiries into Maternal Deaths in the United Kingdom, and found that neurological conditions represented the third most common cause of death among pregnant women. Moreover, the review notes that women who experience migraines are more than twice as likely to experience pre-eclampsia—high blood pressure and protein in the urine—than those who do not. Thus, women should be instructed to inform their health care providers if their headache symptoms differ in any way from those associated with their usual migraines.
Other conditions associated with headache during pregnancy include idiopathic intracranial hypertension (IIH) and cerebral venous thrombosis (CVT). IIH is a rare condition characterized by an accumulation of pressure inside the skull, and is more prevalent in obese women of childbearing age than in other populations. The condition can arise for the first time or worsen during pregnancy, and can be fatal if not addressed immediately. CVT is a blood clot in the dural venous sinuses, which are responsible for draining blood from the brain. Pregnancy is a recognized risk factor for this condition, and caesarean section, infection, anemia, and vomiting further increase one’s chances of developing CVT. Headache occurs as a symptom in 80-90% of all patients, and is often the first sign that something is awry.
Significantly, increased intracranial pressure has also been associated with sleep apnea, a condition that is linked to a heightened risk of pregnancy complications such as high blood pressure and gestational diabetes. While research on the relationship between pregnancy, headache, and sleep problems is still underway, a growing number of obstetricians have recognized the possible connections between pregnancy and sleep disorders.
Where headache during pregnancy is concerned, the health—and the lives—of both the patient and child can be contingent upon a practitioner’s ability to recognize and address the source of a woman’s head pain. This being the case, a number of steps should be taken to ensure that pregnant women suffering from head pain are thoroughly evaluated and receive proper care. Most importantly, both general practitioners and obstetricians should be aware of the symptoms of rarer and more severe causes of headaches. Moreover, pregnant women should be assured of the safety of brain imaging, which can help pinpoint the cause of headaches deemed worthy of further investigation. Finally, once the root cause of a headache has been discovered, appropriate care should be administrated, be it in the form of emergency intervention or an exploration of options for relieving migraine headaches without drugs.
At Rowe Neurology Institute, we have the most current diagnostic tools, and a staff of neurologists and integrated caregivers who specialize in diagnosing and treating headaches and migraines. We’ve treated literally tens of thousands of headache patients in the Kansas City region at our Headache Center. Take your life back from migraines. We’ll show you how.