A recent study at Montefiore Health System and Albert Einstein College of Medicine of Yeshiva University suggests that pregnant women who suddenly develop severe headaches with high blood pressure, having no history of headaches might be at risk of complications, such as preeclampsia. Researchers have offered clinical recommendations to facilitate diagnostic decisions in such cases.

Pregnancy Headaches And Preeclampsia

Preeclampsia, previously known as toxemia, usually occurs during the second or third trimester. It may be associated with abnormal interactions of blood vessels supplying the placenta. While some patients remain asymptomatic, general signs and symptoms include elevated blood pressure, headaches, blurred vision and abdominal pain. Treatment varies from bed rest to premature delivery, depending on the severity of the condition and age of fetus.

Published in the journal Neurology, lead author Matthew S. Robbins, M.D., Director of Inpatient Services at Montefiore Headache Center, Chief of Neurology at Jack D. Weiler Hospital of Montefiore, and Associate Professor of Clinical Neurology at Einstein said that headaches during pregnancy were fairly common. This often makes distinguishing a persistent, preexisting migraine from a pregnancy-related headache difficult.

Data Analysis And Results

Dr Robbins and her team analyzed records of all pregnant women, with headaches, who had been referred for neurological consultation at the Weiler Hospital over the course of five years. This comprised of 140 women with an approximate age of 29. Majority of the patients were African-American or Hispanic.

Of the total participants, 91 women had primary headaches, of which 90 percent were migraine. Of the 49 women with secondary headaches, 51 percent were diagnosed with pregnancy-induced hypertension, including 38 percent with preeclampsia.  

Strong Connection Established: Headache In Pregnancy

The most significant marker of a secondary headache in pregnant women was found to be high blood pressure. Compared with pregnant women who had a headache but normal blood pressure, women with both these conditions were at a 17-fold increased chance of having some underlying condition or combination – in most cases, preeclampsia.

Moreover, another important aspect to consider during pregnancy-related headaches was a history of such occurrences. If there is no prior history, there is a five-fold increased chance that the secondary headache is due to some other major problem. Other warning signs and symptoms observed during the study were fever, seizures and psychiatric issues.

“Our study suggests that physicians must pay close attention to a pregnant woman presenting with a severe headache, especially if it accompanies elevated blood pressure or no prior history of headache. Such patients should be immediately referred for neuroimaging and monitoring for preeclampsia”, said Dr Robbins.