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Headaches During Pregnancy

Antenatal Obstetrics 

Headaches during a pregnancy are common, however, the diagnosis and management can be difficult.  It is reported by up to 80% of women during their pregnancies.

Most headaches are migraines or tension headaches.  It is very rare for a headache to signal a life threatening condition, however, this is still of major concern.

Types of Headache

PrimaryMigraine
Tension
Cluster
common in pregnancy
common in pregnancy
uncommon in pregnancy
SecondaryHead trauma
VascularIntracranial
Substance
Infections
Metabolic
Cranial
Neuralgia
Hypertension, pre-eclampsia, subarachnoid haemorrhageMeningitis, tumours
Cocaine, alcohol
Sepsis
Hypoglycaemia, hypoxia
Tooth, eye, neck conditions
Bells palsy

Symptoms which may need more urgent review:

  • Sudden onset headache, or significant change in chronic headache
  • Neurological signs or symptoms (visual changes, walking and speech changes)
  • Change in level of consciousness
  • Neck stiffness
  • Fever
  • History of recent head trauma
  • History of hypertension

Management

If there are any of the symptoms listed above, you should seek urgent medical review.  Further investigations may be required depending on the symptoms.

Medications that can be used for headache during pregnancy include paracetamol, caffeine, morphine, maxalon, metoprolol and prednisone.

Anti-inflammatories such as neurofen and migraine specific medications are not recommended during pregnancy.

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