Headache in Pregnancy
Headache is a common source of trouble -to the pregnant women and the Obstetrician alike.
There is a very informative article in The Obstetrician and Gynecologist.
So basically , evaluation of a woman presenting with headache in pregnancy should focus on ruling out the sinister causes of headache. ( ‘Red flags’)
The History should include-
- Duration, location, frequency, severity, of the pain.
2. Associated symptoms( throbbing, any weakness, vomiting, diplopia, visual loss, scotomata
3. Family history
4. Past obstetric history
5. Aggravating or relieving factors.
6. If delivered- ask if she received any pain relief , if LSCS- type of anesthesia.
The ‘ Red Flag‘ signs are-
- Rapid time to peak (within seconds to 5 min)- Thunderclap headache
2. Change with posture.
3. Change in frequency or associated symptoms.
4. Severe pain
5. Neurological symptoms
6. Fever or Neck Stiffness
7. Jaw claudication/ visual disturbance.
8. New onset headache in HIV patient or cancer patient.
Involving a Neurologist in the evaluation is important in the detection and treatment of serious causes of Headache.
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