Headaches

Headaches can be a disturbing symptom in pregnancy. They can also be extremely severe. They are a common thing in pregnancy, mostly occurring in the first and third trimesters. Most are mild in nature.

BY DR. BLASSIO TENSION
Tension headaches are likely to occur for the first time in pregnancy or to be severely exacerbated by pregnancy. They are much more common than migraine headaches.

CAUSES

EMOTIONAL TENSION
This is the most common cause. If the headache is migraine. It is occipital (headache with neck pain), and is constant. It is most likely due to anxiety and uncertainty of the future with a forthcoming baby.

HORMONES
Hormonal stimulation causes increase in vascularity (blood vessels) of nasal lining which mimics changes caused by allergy or infection. This may block the sinus opening causing sinusitis. It may cause frequent nosebleeding accompanied by headache. This also leads to sinusitis (an inflammation of one or more of the—hollow cavities within the cheek bones found around the eyes and behind the nose) and headaches.

ECLAMPSIA OR PRE-ECLAMPSIA
This causes a constant throbbing or splitting headache which can either be frontal, occipital (at the back of the head) or biparietal (on the sides). It is usually accompanied by generalized oedema (abnormal accumulation of fluid beneath the skin) and hypertension. The headache can be very severe.

OTHER CAUSES CAN BE:
o Infections such as urinary tract infections, malaria, typhoid or septicaemia (blood poisoning).
o Metabolic states such as dehydration, hypoglycaemia (low blood sugar), electrolyte (salts that conduct electricity and are found in the body fluid, tissue and blood) and hormonal imbalances.
o Toothache and other pregnancy related complications.

These factors may be directly or indirectly related to pregnancy.

MANAGING
In general, unnecessary use of dregs should be avoided in early pregnancy. Minor headaches should be managed without use of drugs whenever possible. If endurance is possible, the better for an expectant mum. However, when specific treatment is indicated, the foetal drug effects must be considered.

All headaches in pregnancy must be properly diagnosed and adequately investigated. Treatment is then given depending on the specific diagnosis.

While treating the headache, the pregnancy must be protected. Avoid over the counter drugs. This will prevent use of unnecessary and at times potentially dangerous drugs. Remember that no drug is absolutely safe in pregnancy. Therefore, use prescribed drugs after proper evaluation and diagnosis.

Where analgesics are used, very simple ones like Panadol should be preferred to avoid undue complications.

END: PG17/48