OB

Headache in Pregnancy

search

Headache in Pregnancy, Migraine in Pregnancy, Antepartum Headache, Postpartum Headache

  1. Tension Headache
  2. Migraine Headache
    1. Improves with pregnancy in up to 70% of patients
    2. Some cases of first Migraine occur in first trimester
      1. Associated with aura
  3. Chronic Daily Headache
  1. See Headache for other causes
  2. See Headache Red Flags
  3. Pregnancy Induced Hypertension (Preeclampsia)
    1. Consider after 20 weeks
  1. See Headache for other causes
  2. See Headache Red Flags
  3. Pregnancy Induced Hypertension (Preeclampsia)
    1. May occur up to 6 weeks after delivery
    2. Critical diagnosis commonly missed in postpartum patients (Magnesium IV is drug of choice)
    3. Evaluate for Hypertension and Proteinuria (or alternative criteria) in all Postpartum Headache patients
  4. Posterior Reversible Encephalopathy Syndrome (PRES)
  5. Post-epidural Headache
    1. Spinal Headache (Post-Lumbar puncture headache)
    2. Pneumocephalus
  6. Cerebral Venous Thrombosis (Cortical Vein Thrombosis)
  7. Spontaneous Subarachnoid Hemorrhage
  8. Meningitis
  9. Pituitary Apoplexy
  • References
  1. Jhun, Weinstock and Jaque in Herbert (2017) EM:Rap 17(1): 14-5
  2. Johnson (2004) Prim Care Office Pract 31:417-28
  3. Gregory (2018) Am Fam Physician 98(9): 595-602 [PubMed]
  4. Silberstein (2004) Neurol Clin 22:727-56 [PubMed]