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    Red flags for pregnant women with headaches

    Women who present with an acute headache during pregnancy may have a secondary disorder requiring attention, according to a new single-center retrospective study in Neurology.

    More: Missing stroke in young women

    Researchers studied 140 women who presented with an acute headache at the emergency department, labor and delivery triage, or antepartum units at the Jack D Weiler Hospital in Bronx, New York from July 2009 to June 2014 and subsequently had a neurology consult requested. The average age of the women was 29 ± 6.4 years and 56.4% of them presented during the third trimester. Sixty-five percent of diagnoses were primary disorders and 35% were secondary disorders. Demographics, gestational ages, and most headache features were similar across both groups.

    Overall, 91.2% of primary disorders were migraine and 51% of secondary headache disorders were hypertensive. Following univariate analysis, secondary headaches were linked to a lack of headache history (36.7% vs 13.2%, P = 0.0012), fever (8.2% vs 0.0%, P = 0.014), abnormal neurologic examination (34.7% vs 16.5%, P = 0.014), seizures (12.2% vs 0.0%, P = 0.0015), and elevated blood pressure (55.1% vs 8.8%, P < 0.0001). The association between a secondary headache and lack of headache history and elevated blood pressure increased following multivariate logistic regression.

    The investigators concluded that roughly a third of the headaches were from secondary disorders. They believe that in pregnant patients with headache, vigilance is important in the absence of a history of headache and if a woman has hypertension, seizures, or fever.

    NEXT: Could an environmental toxin lead to miscarriages? 

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

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