Why do pregnant women have headaches?
In the first trimester, hormonal levels change, the volume of circulating blood increases, and vascular tone changes. Add nausea, which causes a woman to drink and eat less, a sudden refusal of coffee, lack of sleep and anxiety - and you get a typical picture of a tension headache. In the second and third trimester, load on the cervical spine, changes in posture, sleep disturbances and anemia occur. Migraine stands out separately: for many women, attacks become less frequent during pregnancy, but for some, on the contrary, they become more frequent, especially in the first trimester.
- Hormonal changes
- Lack of sleep and fatigue
- Dehydration due to toxicosis
- Long breaks from eating
- Abrupt caffeine withdrawal
- Anemia
- Neck muscle tension and changes in posture
Preeclampsia: the main thing to rule out
Preeclampsia usually develops after the 20th week and is manifested by increased blood pressure and the appearance of protein in the urine. The headache is different: it is severe, difficult to relieve with conventional measures, and is often accompanied by visual disturbances—spots, flashes, blurring—as well as pain in the right hypochondrium, nausea, and sudden swelling of the face and arms. The condition is dangerous and requires immediate evaluation. That is why it is important for a pregnant woman to have a blood pressure monitor at home and, if she has a headache, first of all measure her blood pressure, and not look for a pill.
- Blood pressure 140/90 or higher
- Protein in urine
- Visual impairment
- Pain in the right hypochondrium
- Swelling of the face and hands, rapid weight gain
- Nausea and vomiting in the second half of pregnancy
What can you do safely?
The first measures do not involve drugs and often help. You need to drink water, eat if there was a long break, lie down in a quiet, dark, ventilated room and try to sleep. A cool compress on the forehead, a gentle massage of the neck and shoulders, and a light walk in the fresh air help. It is important to establish regular sleep, not skip meals, drink enough fluids and not suddenly give up caffeine if the woman drank coffee before pregnancy. All medications, including usual painkillers, are used only as prescribed by a doctor.
- Drink and small snack
- Relax in a quiet, darkened room
- Cool compress
- Airing and walking
- Regular sleep and nutrition
- Soft exercises for the neck
- Avoiding self-medication with painkillers
Survey
The examination begins with something simple but important: measuring blood pressure in both arms, assessing edema and weight gain, and testing urine for protein. If necessary, a general blood test, liver and kidney function indicators, and platelet levels are prescribed. If the headache is unusual, accompanied by neurological disorders, or does not fit into the usual pattern, the pregnant woman is consulted by a neurologist. Magnetic resonance imaging without contrast, with justified indications, is acceptable during pregnancy, but they try not to use computed tomography.
- Blood pressure measurement
- General urine analysis and protein in urine
- General blood test
- Liver enzymes and platelets for suspected preeclampsia
- Examination by a neurologist for atypical pain
- MRI without contrast according to strict indications
Migraine during pregnancy
It is important for women with migraines to discuss a plan of action in advance with the doctor who is managing the pregnancy. The main tactic is to prevent attacks using non-drug means: stable sleep, regular meals, sufficient drinking, moderate activity, dealing with stress. The medications a woman took before pregnancy often require review because not all of them are approved. It is important to remember that migraine with aura is associated with a slightly higher risk of vascular complications, so your blood pressure is monitored especially closely, and any new symptoms are discussed with your doctor.
- Pre-agreed plan with your doctor
- Stable sleep and nutrition patterns
- Drinking enough
- Stopping previous medications without consultation
- Special blood pressure control for migraine with aura
- Immediate treatment if the nature of the attacks changes
