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Sakit kepala parah pada wanita hamil : Kapan harus cemas

Date:

August 19, 2015

Source:

Albert Einstein College of Medicine

Summary:

Rekomendasi klinis pertama untuk membuat keputusan diagnostik tentang sakit kepala parah pada wanita hamil telah ditawarkan oleh para ahli . Sakit kepala , mereka mengatakan , bisa menjadi indikasi komplikasi kehamilan.

............ " Sakit kepala selama kehamilan sangat umum , tetapi tidak selalu mudah untuk membedakan jika berulang , sudah ada kondisi migrain dan sakit kepala yang disebabkan oleh komplikasi kehamilan, " kata pemimpin penulis Matthew S . Robbins , MD , direktur layanan rawat inap di Montefiore Headache Center, kepala neurologi di Jack D. Weiler Rumah Sakit Montefiore , dan profesor neurologi klinis di Einstein .........more

Severe headache in pregnant women: When to worry

Researchers offer first clinical
recommendations

Date:

August 19, 2015

Source:

Albert Einstein College of Medicine

Summary:

The first clinical recommendations for
making diagnostic decisions about severe headaches in pregnant women have been
offered by experts. Headaches, they say, can be an indication of pregnancy
complications at times.

....................

If a pregnant woman with high blood
pressure and no history of headache suddenly develops a headache that quickly
gets worse, she could be at risk for pregnancy complications, including
preeclampsia, which put both the mother and fetus at risk. These and other
findings from a new study conducted by researchers at Montefiore Health System
and Albert Einstein College of Medicine of Yeshiva University, offer the first
clinical recommendations for making diagnostic decisions about headaches in
pregnant women. The study, the largest of its kind, was published online in the
journalNeurology.

"Headaches during pregnancy are
quite common, but it is not always easy to distinguish between a recurring,
preexisting migraine condition and a headache caused by a pregnancy
complication," said 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. "Our study suggests that physicians should pay close attention
when a pregnant woman presents with a severe headache, especially if she has
elevated blood pressure or lack of past headache history. Those patients should
be referred immediately for neuroimaging and monitoring for preeclampsia."

Preeclampsia (previously called toxemia)
typically occurs during the second or third trimester of pregnancy and may be
related to an abnormal interaction of blood vessels that supply the placenta.
Symptoms and signs can include high blood pressure, headaches, blurry vision,
or abdominal pain, although some patients may have no symptoms. Depending on
the severity and the age of the fetus, treatment ranges from bed rest for mild
preeclampsia to premature delivery if the condition is severe.

Dr. Robbins and colleagues analyzed
records of every pregnant woman with headache who had been referred for a
neurological consultation at Weiler Hospital over a five-year period. The study
involved 140 women with an average age of 29. A large majority of the patients
were Hispanic or African-American, reflecting the makeup of the Bronx population.

Most (91) of the 140 women had primary
headaches, 90 percent of which were migraines. Among the 49 patients with
secondary headache, 51 percent were diagnosed with pregnancy-related high blood
pressure, including the 38 percent of women who had preeclampsia.

The most telling indicator of a
secondary headache among pregnant women proved to be high blood pressure.
Compared to pregnant women with headache but no high blood pressure, women with
headache plus high blood pressure faced a 17-fold increased likelihood that
their headaches were caused by some other condition. "In most of these
patients, their elevated blood pressure was driven by preeclampsia," said
Dr. Robbins.

The researchers found that another red
flag for a headache that should be taken seriously was lack of a previous
history of headache, which was associated with a five-fold increased likelihood
that the headache was secondary to something else. Other warning signs were
fever, seizures, and headaches in the absence of phonophobia (sound sensitivity)
and psychiatric problems.







Story Source:

The above post is reprinted from materials provided by Albert Einstein College of Medicine. Note: Materials may be edited for content
and length.







Journal Reference:

1.   
Matthew S. Robbins, Constantine
Farmakidis, Ashlesha K. Dayal, and Richard B. Lipton. Acute headache
diagnosis in pregnant women: a hospital-based study. Neurology,
August 2015 DOI: 10.1212/WNL.0000000000001954

http://www.sciencedaily.com/releases/2015/08/150819170903.htm

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