Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers

Headaches are common in pregnancy and the immediate postpartum period. Fortunately >90% of these headaches are primary and benign. Generally, the most common primary headache disorders have a peak incidence at a younger age and affect women disproportionately, especially in the reproductive p...

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Main Authors: J Moodley, N Mayat, N Moran
Format: Article
Language:English
Published: South African Medical Association 2018-10-01
Series:South African Medical Journal
Online Access:http://www.samj.org.za/index.php/samj/article/download/12430/8635
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author J Moodley
N Mayat
N Moran
author_facet J Moodley
N Mayat
N Moran
author_sort J Moodley
collection DOAJ
description Headaches are common in pregnancy and the immediate postpartum period. Fortunately >90% of these headaches are primary and benign. Generally, the most common primary headache disorders have a peak incidence at a younger age and affect women disproportionately, especially in the reproductive phase of life. The higher incidence in females may reflect the relationship between headache and sex hormones, particularly oestrogen. In pregnancy, most headaches in the first trimester are primary, while the incidence of secondary headaches increases in the third trimester and the immediate postpartum period. This probably reflects when pre-eclampsia and changes in the coagulation system are the greatest. Despite this, 50 - 70% of headaches in late pregnancy have a primary benign cause. Common causes of headaches in pregnancy and the postpartum period are: migraine (vascular), tension headache (brain tumour), cluster headache (severe pre-eclampsia/eclampsia) and cough (postdural puncture, reversible cerebral vasoconstriction syndrome, idiopathic intracranial hypertension, cerebral venous thrombosis). This article presents two cases of maternal deaths arising from lack of awareness that acute severe headaches in pregnancy may have serious underlying pathology, and that persistent headache should be regarded as a ‘red flag’, as suggested by neurologists.
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spelling doaj.art-4e7d4022678c407cab1740d0d3656ea02024-01-02T16:26:14ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352018-10-011081080780810.7196/SAMJ.2018.v108i10.13060Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneersJ MoodleyN MayatN MoranHeadaches are common in pregnancy and the immediate postpartum period. Fortunately >90% of these headaches are primary and benign. Generally, the most common primary headache disorders have a peak incidence at a younger age and affect women disproportionately, especially in the reproductive phase of life. The higher incidence in females may reflect the relationship between headache and sex hormones, particularly oestrogen. In pregnancy, most headaches in the first trimester are primary, while the incidence of secondary headaches increases in the third trimester and the immediate postpartum period. This probably reflects when pre-eclampsia and changes in the coagulation system are the greatest. Despite this, 50 - 70% of headaches in late pregnancy have a primary benign cause. Common causes of headaches in pregnancy and the postpartum period are: migraine (vascular), tension headache (brain tumour), cluster headache (severe pre-eclampsia/eclampsia) and cough (postdural puncture, reversible cerebral vasoconstriction syndrome, idiopathic intracranial hypertension, cerebral venous thrombosis). This article presents two cases of maternal deaths arising from lack of awareness that acute severe headaches in pregnancy may have serious underlying pathology, and that persistent headache should be regarded as a ‘red flag’, as suggested by neurologists.http://www.samj.org.za/index.php/samj/article/download/12430/8635
spellingShingle J Moodley
N Mayat
N Moran
Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers
South African Medical Journal
title Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers
title_full Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers
title_fullStr Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers
title_full_unstemmed Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers
title_short Acute severe headaches in pregnancy are a ‘red flag’: A review based on case reports and key messages for healthcare practioneers
title_sort acute severe headaches in pregnancy are a a€ red flaga€™ a review based on case reports and key messages for healthcare practioneers
url http://www.samj.org.za/index.php/samj/article/download/12430/8635
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