scholarly journals Headache During Gestation: Evaluation of 1101 Women

Author(s):  
Eliana M. Melhado ◽  
Jayme A. Maciel ◽  
Carlos A.M. Guerreiro

Objective:The purpose of this study was to evaluate the presence of headache in women with a previous history or new-onset headache during the current gestation, classify the findings, and describe the clinical characteristics and outcome of the headache.Methods:From January/1998 to June/2002 we prospectively evaluated 1101 pregnant women (12-45 years old), with a history of headache, at two prenatal clinics and an inpatient obstetric public hospital. Women were interviewed using a semi-structured questionnaire during the first, second, and third gestation trimesters and immediately after delivery. All interviews were conducted by one of the authors, using the International Headache Society Classification (IHSC-2004).Results:In 1029 women there was a history of headache prior to the current pregnancy, 36 (3.4%) women first experienced headache during this pregnancy and 40 patients experienced new types of headache. In these 76 patients with new onset headache during pregnancy, 40 had secondary headache (52.6%), 31 had primary headache (40.8%), and 5 had headache not classified elsewhere (6.6%). According to IHSC- 2004 criteria, we found migraine in 848/1029 women (82.4%), with pregestational headache.Conclusions:Most of the pregnant women presented with headache, mainly in migraine, prior to pregnancy, and most of the headaches improved or disappeared during the second and third gestation trimester. In a relatively small number of pregnant women, a new type of headache started during the gestation.

Migraine ◽  
2020 ◽  
Author(s):  
Dhruv Bansal ◽  
Pritesh Pranay ◽  
Fayyaz Ahmed

Medication overuse headache (MOH) is defined in the latest ICHD-3 criteria as a secondary headache caused by worsening of a pre-existing headache (usually a primary headache) owing to overuse of one or more attack-aborting or pain-relieving medications. MOH can be debilitating and results from biochemical and functional brain changes induced by certain medications taken too frequently. Various risk factors some modifiable, other non-modifiable (Multiple Gene Polymorphisms) have been hypothesised in MOH. Psychiatric co-morbidities in MOH are noticeably (anxiety and depression) found to be co morbid disorders by more than chance. This has to be managed effectively along with treatment strategies for MOH for efficacious response to withdrawal treatment. Ample literature and clinical evidence shown in prospective trials, that withdrawal therapy is the best treatment for MOH. The mainstay of MOH treatment is not only to detoxify the patients and to stop the chronic headache but also, most likely, to improve responsiveness to acute or prophylactic drugs. Studies advocating prophylactic treatment with good response to mainly topiramate and OnabotulinumtoxinA do exist, less prominent for prednisolone, however, not recommended for every patient. Management may be complex and must be done via MDT approach with involvement of specialists when needed along with incorporating adequate treatment of acute withdrawal symptoms, educational and behavioural programs to ensure patient understanding of the condition and compliance. There are arguments on either sides of inpatient and outpatient withdrawal for MOH patients dependent heavily on the individual circumstances i.e. patient’s motivation, the duration of the overuse, the type of overused drugs, possible previous history of detoxification failures and co morbidities. Treatment trials are still required to determine for clinicians the best evidence-based approach for helping these patients break their headache cycle.


2005 ◽  
Vol 63 (4) ◽  
pp. 934-940 ◽  
Author(s):  
Eliana Melhado ◽  
Jayme A. Maciel Jr ◽  
Carlos A.M. Guerreiro

OBJECTIVE: To evaluate the presence of menstrual headaches prior to pregnancy according to the International Headache Society (IHS) classification criteria, 2004, and also study the outcome (frequency and intensity) of these pre-existing headaches during the gestational trimesters. METHOD: This study involved 1,101 pregnant women (12 to 45 years old). A semi-structured questionnaire was used to interview the women during the first, second and third gestational trimesters as well as after delivery. All the interviews were conducted by one of the researchers by applying the IHS Classification (IHSC-2004). RESULTS: A 1,029 women out of the 1,101 women interviewed presented headaches prior to gestation, which made it possible to study headaches in 993 women during the gestational trimesters. Menstrually related headaches were presented by 360 of the 993 women. Migraine was reported by 332/360 women (92.22%) with menstrual headaches and 516/633 women (81.51%) without menstrual headaches, respectively, prior to gestation. The majority of the women with menstrual migraine presented a headache improvement or disappearance during gestation (62.22% during the first trimester; 74.17% during the second trimester; 77.78% during the third trimester). CONCLUSION: Most of the pregnant women with menstrual or non-menstrual headaches prior to gestation presented migraine, which either improved or disappeared during pregnancy. Women who suffered from non-menstrual headaches improved during pregnancy but not as much as women with menstrual headaches.


Author(s):  
Nasloon Ali ◽  
Aysha S. Aldhaheri ◽  
Hessa H. Alneyadi ◽  
Maha H. Alazeezi ◽  
Sara S. Al Dhaheri ◽  
...  

Gestational diabetes mellitus (GDM) increases the risk of adverse pregnancy outcomes in any pregnancy and recurrence rates are high in future pregnancies. This study aims to investigate the effect of self-reported history of previous GDM on behaviors in a future pregnancy. This is an interim cross-sectional analysis of the pregnant women who participated in the Mutaba’ah Study between May 2017 and March 2020 in the United Arab Emirates. Participants completed a baseline self-administered questionnaire on sociodemographic and pregnancy-related information about the current pregnancy and previous pregnancies. Regression models assessed the relationships between self-reported history of GDM and pre-pregnancy and pregnancy behaviors in the current pregnancy. Out of 5738 pregnant parous women included in this analysis, nearly 30% (n = 1684) reported a history of GDM in a previous pregnancy. Women with a history of previous GDM were less likely to plan their current pregnancies (adjusted odds ratio (aOR): 0.84, 95% confidence interval (CI) 0.74–0.96) and more likely to be worried about childbirth (aOR: 1.18, 95% CI 1.03–1.36). They had shorter interpregnancy intervals between their previous child and current pregnancy (aOR: 0.88, 95% CI 0.82–0.94, per SD increase). There were no significant differences between women with and without a history of GDM in supplement use, sedentary behavior, or physical activity before and during this current pregnancy. Nearly a third of parous pregnant women in this population had a history of GDM in a previous pregnancy. Pregnant women with a previous history of GDM were similar to their counterparts with no history of GDM in the adopted pre-pregnancy and prenatal health behaviors. More intensive and long-term lifestyle counseling, possibly supported by e-health and social media materials, might be required to empower pregnant women with a history of GDM. This may assist in adopting and maintaining healthy prenatal behaviors early during the pregnancy or the preconception phase to minimize the risk of GDM recurrence and the consequential adverse maternal and infant health outcomes.


2018 ◽  
Vol 38 (06) ◽  
pp. 619-626 ◽  
Author(s):  
Brigid Dwyer

AbstractPosttraumatic headaches are among the most challenging complaints after mild traumatic brain injury (mTBI). They are a debilitating problem experienced by patients after TBI of all severities. Up to 90% of mild TBI patients experience headache, particularly if female and with a premorbid history of primary headache. Tension headache has classically been the most common subtype, but in military populations migraine has dominated. Posttraumatic headache encompasses a spectrum of headache types that overlap heavily with common primary headache disorders, but also autonomic cephalgias as well as several secondary headache conditions. It is important to understand the evolution of postconcussion syndrome as a concept, and the challenges associated with diagnosing and treating multidomain drivers effectively. The first-line treatments for posttraumatic headache are typically the same as those used in nontraumatic headache, with additional considerations for cognitive side effects, posttraumatic epilepsy, and coexisting injuries resulting in neuropathic pain or medication overuse.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261895
Author(s):  
Meron Admasu Wegene ◽  
Negeso Gebeyehu Gejo ◽  
Daniel Yohannes Bedecha ◽  
Amene Abebe Kerbo ◽  
Shemsu Nuriye Hagisso ◽  
...  

Introduction There is substantial body of evidence that portrays gap in the existing maternal and child health continuum of care; one is less attention given to adolescent girls and young women until they get pregnant. Besides, antenatal care is too late to reduce the harmful effects that a woman’s may have on the fetus during the critical period of organogenesis. Fortunately, preconception care can fill these gaps, enhance well-being of women and couples and improve subsequent pregnancy and child health outcomes. Therefore, the main aim of the current study was to assess preconception care utilization and associated factors among pregnant women attending antenatal care clinics of public health facilities in Hosanna town. Methods A facility based cross-sectional study design was carried out from July 30, 2020 to August 30, 2020. Data were collected through face-to-face interview among 400 eligible pregnant women through systematic sampling technique. Epi-data version 3.1 and SPSS version 24 was used for data entry and analysis respectively. Both bivariable and multivariable logistic regression analysis was conducted to identify association between dependent and independent variables. Crude and adjusted odds ratio with respective 95% confidence intervals was computed and statistical significance was declared at p-value <0.05. Result This study revealed that 76 (19%, 95% Cl (15.3, 23.2) study participants had utilized preconception care. History of family planning use before the current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741), previous history of adverse birth outcomes (AOR = 3.15; 95% Cl (1.650, 6.005), poor knowledge on preconception care (AOR = 0.18; 95% Cl (0.084, 0.379) and receiving counseling on preconception care previously (AOR = 2.82; 95% Cl (1.221, 6.493) were significantly associated with preconception care utilization. Conclusions The present study revealed that nearly one-fifth of pregnant women have utilized preconception care services. History of family planning use before the current pregnancy, previous history of adverse birth outcomes, poor knowledge on preconception care and receiving counseling on preconception care previously were significantly associated with preconception care utilization. Integrating preconception care services with other maternal neonatal child health, improving women’s/couples knowledge & strengthening counseling services is pivotal.


Cephalalgia ◽  
2007 ◽  
Vol 27 (8) ◽  
pp. 904-911 ◽  
Author(s):  
CJ Schankin ◽  
U Ferrari ◽  
VM Reinisch ◽  
T Birnbaum ◽  
R Goldbrunner ◽  
...  

Eighty-five brain tumour patients were examined for further characteristics of brain tumour-associated headache. The overall prevalence of headache in this population was 60%, but headache was the sole symptom in only 2%. Pain was generally dull, of moderate intensity, and not specifically localized. Nearly 40% met the criteria of tension-type headache. An alteration of the pain with the occurrence of the tumour was experienced by 82.5%, implying that the preexisting and the brain tumour headaches were different. The classic characteristics mentioned in the International Classification of Headache Disorders (worsening in the morning or during coughing) were not found; this might be explained by the patients not having elevated intracranial pressure. Univariate analysis revealed that a positive family history of headache and the presence of meningiomas are risk factors for tumour-associated headache, and the use of β-blockers is prophylactic. Pre-existing headache was the only risk factor according to logistic regression, suggesting that patients with pre-existing (primary) headache have a greater predisposition to develop secondary headache. Dull headache occurs significantly more often in patients with glioblastoma multiforme, and pulsating headache in patients with meningioma. In our study, only infratentorial tumours were associated with headache location, and predominantly with occipital but rarely frontal pain.


2020 ◽  
Vol 28 (3) ◽  
pp. 233-243
Author(s):  
O. Erhabor ◽  
S.Y. Mohammad ◽  
L. Bello ◽  
F.U. Onuigwe ◽  
Y. Abdulrahman ◽  
...  

BACKGROUND: Hepatitis B virus infection is a global public health problem. The virus has infected more than one-third of the global population. It has been estimated that 360 million chronic carriers are living around the world with a high risk for developing cirrhosis, hepatic carcinoma and hepatic failure. OBJECTIVE: The aim of this study was to determine the prevalence of some hepatitis B markers among pregnant women attending antenatal clinic in Sokoto Specialist Hospital, Nigeria. METHODS: The hepatitis testing was carried out using the Skytec-Rapid Diagnostic HBV-5 rapid kit (Skytec-Rapid Diagnostic, USA). The kit is based on lateral flow chromatographic immunoassay for the qualitative detection of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in human serum or plasma. Panel format can conveniently test for five targets at once and utilizes all markers to help distinguish between acute and chronic infections. RESULTS: Out of 117 pregnant women tested, 15 were positive for HBsAg (12.8%), 6 positive for HBsAb (5.1%), 1 for HBeAg (0.9%), 14 tested positive for HBeAb (12.0%), and 14 tested for HBcAb (12.0%). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on ethnicity. HBsAb was significantly higher among the Hausa ethnic group (p= 0.001). The prevalence of HBsAb, HBeAg, HBcAb and HBcAb was not affected by ethnicity (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on age. Infection by the hepatitis B virus markers was higher among young adult and middle age groups. The difference was however not statistically significant (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on the educational status, previous history of blood transfusion, jaundice, employment status and previous history of still births among the pregnant subjects. There were no statistically significant differences in the prevalence of Hepatitis B virus markers (p> 0.05). CONCLUSION: The study observed a high prevalence of various hepatitis B viral markers among pregnant women attending antenatal care in Specialist Hospital Sokoto. There is need for routine screening of all pregnant women and infants born to hepatitis B positive mothers. Government and non-governmental organizations should intensify efforts to enlighten the general population on the public health importance of the disease and the importance of hepatitis screening. There is also need for the development of a treatment protocol for the management of pregnant women positive for hepatitis B to prevent mother to child transmission. There is an urgent need for the implementation of evidenced-based best practice of providing universal vaccination against hepatitis B for all hepatitis B negative women of child bearing age in particular and all Nigerians in general.


2020 ◽  
pp. 1-9 ◽  
Author(s):  
Richard J. Shaw ◽  
Daniel Mackay ◽  
Jill P. Pell ◽  
Sandosh Padmanabhan ◽  
David S. Bailey ◽  
...  

Abstract Background Recent work suggests that antihypertensive medications may be useful as repurposed treatments for mood disorders. Using large-scale linked healthcare data we investigated whether certain classes of antihypertensive, such as angiotensin antagonists (AAs) and calcium channel blockers, were associated with reduced risk of new-onset major depressive disorder (MDD) or bipolar disorder (BD). Method Two cohorts of patients treated with antihypertensives were identified from Scottish prescribing (2009–2016) and hospital admission (1981–2016) records. Eligibility for cohort membership was determined by a receipt of a minimum of four prescriptions for antihypertensives within a 12-month window. One treatment cohort (n = 538 730) included patients with no previous history of mood disorder, whereas the other (n = 262 278) included those who did. Both cohorts were matched by age, sex and area deprivation to untreated comparators. Associations between antihypertensive treatment and new-onset MDD or bipolar episodes were investigated using Cox regression. Results For patients without a history of mood disorder, antihypertensives were associated with increased risk of new-onset MDD. For AA monotherapy, the hazard ratio (HR) for new-onset MDD was 1.17 (95% CI 1.04–1.31). Beta blockers' association was stronger (HR 2.68; 95% CI 2.45–2.92), possibly indicating pre-existing anxiety. Some classes of antihypertensive were associated with protection against BD, particularly AAs (HR 0.46; 95% CI 0.30–0.70). For patients with a past history of mood disorders, all classes of antihypertensives were associated with increased risk of future episodes of MDD. Conclusions There was no evidence that antihypertensive medications prevented new episodes of MDD but AAs may represent a novel treatment avenue for BD.


Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Taddese Alemu ◽  
Melaku Umeta

Anemia is a major public health problem worldwide. In Ethiopia, a nationally representative and consistent evidence is lacking on the prevalence and determinants during pregnancy. We conducted an in-depth analysis of demographic and health survey for the year 2011 which is a representative data collected from all regions in Ethiopia. Considering maternal anemia as an outcome variable, predicting variables from sociodemographic, household, and reproductive/obstetric characteristics were identified for analyses. Logistic regression model was applied to identify predictors atP<0.05. The prevalence of anemia among pregnant women was 23%. Maternal age, region, pregnancy trimester, number of under five children, previous history of abortion (termination of pregnancy), breastfeeding practices, and number of antenatal care visits were key independent predictors of anemia during pregnancy. In conclusion, the level of anemia during pregnancy is a moderate public health problem in Ethiopia. Yet, special preventive measures should be undertaken for pregnant women who are older in age and having too many under five children and previous history of abortion. Further evidence is expected to be generated concerning why pregnant mothers from the eastern part of the country and those with better access to radio disproportionately develop anemia more than their counterparts.


Author(s):  
Jonathan P. Gladstone ◽  
David W. Dodick

In 1988, the International Headache Society created a classification system that has become the standard for headache diagnosis and research. The International Classification of Headache Disorders galvanized the headache community and stimulated nosologic, epidemiologic, pathophysiologic, and genetic research. It also facilitated multinational clinical drug trials that have led to the basis of current treatment guidelines. While there have been criticisms, the classification received widespread support by headache societies around the globe. Fifteen years later, the International Headache Society released the revised and expanded International Classification of Headache Disorders second edition. The unprecedented and rapid advances in the field of headache led to the inclusion of many new primary and secondary headache disorders in the revised classification. Using illustrative cases, this review highlights 10 important new headache types that have been added to the second edition. It is important for neurologists to familiarize themselves with the diagnostic criteria for the frequently encountered primary headache disorders and to be able to access the classification (www.i-h-s.org) for the less commonly encountered or diagnostically challenging presentations of headache and facial pain.


Sign in / Sign up

Export Citation Format

Share Document