Headache in pregnancy

Abstract

Headache is a frequent symptom in women of childbearing age and during pregnancy. Benign and pathologic headaches may change in response to changes in estrogen after conception. Expected patterns of change are described for headaches that occur commonly during pregnancy. In addition, although treatment options are limited during pregnancy, a variety of effective medication and nonmedication treatments are available and should be offered to women with benign headaches that persist into the second trimester of pregnancy.

Migraine Headaches and Preeclampsia: An Epidemiologic Review

“…Women with headaches persisting into the second trimester are less likely to improve. The likelihood of improvement may also depend on history of menstrual migraine, parity, and headache changes during prior pregnancies 37 . Despite the results reported by Callaghan in 1968, in which 17% of women experienced migraine onset during pregnancy, this phenomenon is not common and may indicate a more serious problem 38 .…”

Headaches During Pregnancy

“…76,[85][86][87] Topiramate is also a category D drug because of the possibility of increased birth defects. For example, if the pregnant woman has hypertension, consider a b-blocker or calcium channel blocker.…”

The Quality of Headache Treatment in The United States: Review and Analysis of Recent Data

“…Another important limitation of the indicators is that they do not take into account individual patient factors. Opioids should not be first‐line treatment for most migraineurs, but are the treatment of choice in pregnant migraineurs, or those with cardiovascular or other medical contraindications to other abortive treatments 10 . Other indicators are poorly worded: literal interpretation of indicator 15, for example, would preclude the use of all triptans other than sumatriptan.…”