Some expectant mothers are particularly prone to headaches, especially in early pregnancy. These headaches are usually mild. However, it is important to recognize certain warning signs.

It is usually moderate, bilateral pain, unlike migraine which affects only one side of the head with a sharp, throbbing pain, often accompanied by nausea, vomiting, intolerance to light, certain smells and noise. . Note that in women predisposed to migraines, pregnancy generally signs a period of calm after the first trimester, once the hormonal climate is well established.

If the headaches occur at the end of pregnancy and are accompanied by other manifestations such as ringing in the ears, visual disturbances (sensation of “fly” in front of the eyes), abdominal pain or vomiting, a consultation in urgency is needed. These are warning signs of high blood pressure that can lead to preeclampsia, a potentially serious late-pregnancy complication for mom and baby.

Some women suffer from frequent headaches early in pregnancy, but in isolation they are not a reliable sign of pregnancy. It is an element in a more general table associating in particular a delay of rules, nausea, fatigue, a tenderness of the chest.

The headaches of the first trimester are the consequence of the various physiological modifications which take place with the pregnancy which sets in. Blood volume increases, blood pressure fluctuates, hormones are secreted in quantity, hypoglycaemia is more frequent. Added to this are the fatigue and psycho-emotional tension of early pregnancy. All of these create a climate conducive to headaches.

The various winter ailments (nasopharyngitis, flu syndrome, influenza, etc.) can also cause headaches in the mother-to-be.

The mother-to-be can try to identify the situations that favor her headaches (fatigue, certain smells, thirst, hypoglycemia, coffee consumption, noisy or overheated atmosphere, etc.) and if possible, make sure to avoid them. Rest and fresh air are in any case beneficial. Relaxation and breathing exercises or even prenatal yoga are also important because the “stress” component of headaches should not be neglected.

In principle, self-medication is not recommended during pregnancy. As a precaution it is recommended to consult in case of severe headaches or not passing, fever, flu-like condition. In the meantime, it is possible to take certain medications to relieve the headache. According to the Reference Center on Teratogenic Agents (CRAT) (1), concerning analgesics of step 1:

• paracetamol is the first-line analgesic, regardless of the term of pregnancy. Be careful to respect the dosages (maximum 3 g / day). However, recent studies have drawn attention to the risks of excessive intake of paracetamol for the fetus and the health of the unborn child. A study carried out by the Barcelona Environmental Epidemiology Research Center (2) thus highlighted a link between a regular intake of paracetamol during pregnancy and an increased risk of attention disorders in children, and disorders of the autism spectrum in infants. While waiting for possible new health recommendations, it is therefore advisable to be careful and not to have the paracetamol “reflex” at the slightest pain.
• aspirin can be used occasionally during the first five months of pregnancy (24 weeks of amenorrhea). Beyond 24 weeks, aspirin ≥ 500 mg / day is formally contraindicated until childbirth.
• all NSAIDs (non-steroidal inflammatory drugs) are formally contraindicated from 24 weeks onwards. Before 24 weeks, chronic treatments should be avoided. Note, however, that on several occasions, the review Prescribe has for its part advised against the use of NSAIDs throughout pregnancy. The latest alert follows an observation by the Nord-Pas-de-Calais Pharmacovigilance Center which reported a case of premature closure of the ductus arteriosus (a vessel that connects the pulmonary artery to the aorta of the fetus) in a fetus after a single dose of an NSAID by a woman 8 months pregnant (3). “During the first trimester of pregnancy, because of their pharmacological properties, NSAIDs may expose to an increased risk of spontaneous abortions, and some doubts exist as to heart defects”, had already warned the review in January 2017 (4), in response to the recommendations of the ANSM (French Medicines Agency) against the use of non-steroidal anti-inflammatory drugs from the 6th month of pregnancy (5). As for paracetmol, it is therefore advisable to ‘be very careful.

For the treatment of migraine attacks with triptans, CRAT indicates that sumitrapan can be used regardless of the term of pregnancy. If sumatriptan does not work, rizatripan and zolmitriptan can be used.

On the side of alternative medicine:

• acupuncture can work well for stubborn headaches;
• homeopathy offers different remedies depending on the characteristics of the headache, other associated ailments and their circumstances.

Applying cold compresses or special headache gel packs can help relieve the headache.