Headaches in Pregnancy

By on June 5, 2023

Mild headaches during pregnancy are common because of changes in nutrition, sleep, and stress. However, severe headaches should be medically examined since pregnant women are more susceptible to vascular issues that could result in painful headache symptoms. On the Healthful Woman Podcast, neurologist Dr. Naomi Feuer joins Dr. Nathan Fox, an OB-GYN and maternal-fetal health specialist, to discuss the implications of headaches in pregnancy and symptoms to be aware of.

How Do Headaches Affect Pregnant Women?

Dr. Feuer says that about 20% of patients at her practice are pregnant women, which is a significant percentage. This is partly because doctors want to be more cautious when caring for pregnant women but also because headaches are one of the most common medical symptoms for pregnant women. For women, migraines typically begin in their 20s-30s, which is the same time women start to have children.

Some migraine symptoms, specifically migraine with aura, can worsen during pregnancy, which is why it’s important to be aware of possible changes and get medical attention as soon as possible. Migraine with aura causes visual changes like “a rainbow of colors or flashing lights or zigzag lines” before the headache sets in (Dr. Feuer).

Headache Symptoms

Dr. Feuer explains that “head pain is really along a continuum.” Extreme pain all over the head accompanied by photosensitivity, nausea, nose sensitivity, and lethargy are symptomatic of a classic migraine. If that pain is scaled down to a dull ache on one side of the side, it could be a tension headache or cluster headache. Other symptoms to look out for include thunderclap headaches, which literally sound like a thunderclap in the head. This could be a sign of a hemorrhage or bleeding in the brain. If headaches get worse when standing and better while lying down, this can also be a sign of fluid leaking and pressure changes in the head.

Headache Treatment Options

Treatment for non-pregnant people starts with an MRI to check for brain lesions, bleeding, or brain tumors. Clusters of tiny veins called cavernoma can get entangled and bleed, which will cause pain. There might also be high or low intracranial pressure, which could have a role in head pain.

For pregnant women with new or worsening headache symptoms, Dr. Feuer often suggests a referral to an ophthalmologist. She explains that “if the patient has never had imaging before and their headaches are particularly bothersome and not in line with the classical headaches that might be seen more commonly during pregnancy, my first line would be to probably send them to an ophthalmologist and make sure that there isn’t any papilledema or swelling in their optic nerves.”

Since MRI scanning uses magnets, not radiation, it can also be used for pregnant women to check for bleeding into the pituitary gland since this could be a cause of worsening visual changes for migraine with aura. The pituitary gland is located near the optic nerve and a hemorrhage (bleeding) in the gland could cause the gland to put pressure on that nerve, altering a patient’s sight.

Pregnancy-Safe Headache Medications

Propranolol, magnesium, and CoQ10 are generally considered safe medications for pregnant women. Anti-nausea medications like Reglan and Zofran can also ease the more severe symptoms of migraine headaches. Benadryl can also help because it acts as a sedative.

Contact Us Today

MFM Associates is dedicated to comprehensive pregnancy care. It’s important to take care of your overall health for both you and your child. For more advice on pregnancy care or if you have any questions, please schedule an appointment today with one of our maternal-fetal medicine specialists.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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