Migraine and other headache conditions.

Migraine and other headache conditions are relatively common during pregnancy. Physicians and other primary health care providers should not assume that because a patient presents with headache alone, such symptoms can be taken lightly. Most patients do not develop new-onset headache during pregnancy, and all patients who do develop such a condition must be evaluated thoroughly. Similarly, patients who develop any change in their headache condition must undergo a careful evaluation. Fig. 3.1 is an algorithm to aid in evaluating pregnant patients with headache. Postpartum headaches also must be evaluated and treated appropriately. In most cases of headache during pregnancy and postpartum, the patient is suffering with a benign medical condition. Even so, quality of life is an important consideration in preserving the patient's physical and emotional well-being (102, 103). A stepwise approach to symptomatic treatment should be provided for all patients. A high index of suspicion for nonbenign causes of headache will assist in decreasing morbidity and mortality to the mother and fetus.