[34F] Pregnant with severe headache and other symptoms

Patient Description

A 34-year-old female, currently 23 weeks pregnant with her first child, reports experiencing morning sickness 1 to 2 times a week, heartburn 3 to 4 times a week, and constipation 2 to 3 times a week since the second trimester began. Most concerning is a new, severe headache described as a burning sensation and feeling like electrocution in the brain when coughing or bending down. This headache is sudden in onset, rated 9 out of 10 in severity, and lasts between 5 to 30 seconds. Additionally, the patient has a mild dry cough for 3 to 4 days, dizziness, and nausea, which may be related to morning sickness. The patient has a history of Type 1 diabetes diagnosed at age 5 and a family history of headaches, including migraine tension headaches and cluster headaches. Current medications include Humalog on a sliding scale, Fioricet every 6 hours as needed, Flexeril 10mg twice daily as needed, Seroquel 300mg at bedtime, and Trazodone 200mg at bedtime. The patient reports adverse reactions to Imitrex. No new medications have been started or stopped recently, and there are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions might be causing your symptoms:

  • Pregnancy-related symptoms: Many of your symptoms, such as morning sickness, heartburn, and constipation, are common during pregnancy. Hormonal changes during pregnancy can affect the muscles in your digestive tract and slow your digestion, leading to heartburn and constipation. Morning sickness is also a common symptom in the first trimester of pregnancy.

    • Treatment typically involves lifestyle changes, such as eating smaller, more frequent meals, avoiding foods that trigger symptoms, and staying hydrated. Over-the-counter or prescription medications may also be recommended by your doctor.
  • Cough headaches: A cough headache is a rare type of headache triggered by coughing and other types of straining — such as from sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement.

    • Treatment can include avoiding cough-inducing triggers, taking pain relievers before activities that are known to cause cough headaches, or in severe cases, surgery.
  • Migraines: Given your history of migraines, it's possible that your severe headaches could be related to this. Migraines can sometimes be triggered by changes in your body's hormone levels during pregnancy.

    • Treatment can involve a combination of medications, lifestyle changes, and alternative treatments. Your doctor can help you devise a treatment plan based on your symptoms and health history.

What you can do

  1. For your pregnancy-related symptoms, try to eat smaller, more frequent meals and avoid foods that trigger your symptoms. Stay hydrated and get regular exercise to help with constipation. If your symptoms persist or worsen, consult with your doctor. They may recommend over-the-counter or prescription medications to help manage your symptoms.

  2. For your cough headaches, try to avoid cough-inducing triggers. If your headaches persist or worsen, consult with your doctor. They may recommend taking pain relievers before activities that are known to cause cough headaches.

  3. For your migraines, try to identify and avoid potential triggers. This could include certain foods, smells, or activities. If your migraines persist or worsen, consult with your doctor. They may recommend a combination of medications, lifestyle changes, and alternative treatments to help manage your symptoms.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe headache that comes on suddenly
  • Headache accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • Headache after a head injury, especially if the headache worsens
  • Chronic, progressive headache that's accompanied by other symptoms, such as loss of sensation or vision disturbances
  • Headache with shortness of breath
  • Any headache during pregnancy that is not relieved by over-the-counter medication

Remember, I'm an AI and this advice is based on the information you provided. Always consult with a healthcare professional for a formal diagnosis and treatment options.

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10 mo ago

People Also Ask


What are common causes of headaches during pregnancy?

Common causes of headaches during pregnancy include hormonal changes, increased blood volume, stress, lack of sleep, and dehydration. It's important to consult with a healthcare provider to determine the specific cause and appropriate treatment.


How can I manage heartburn and constipation during pregnancy?

To manage heartburn and constipation during pregnancy, try eating smaller, more frequent meals, avoid trigger foods, stay hydrated, and engage in regular exercise. Over-the-counter medications may also be recommended by your doctor.


What are cough headaches and how are they treated?

Cough headaches are a rare type of headache triggered by coughing or other straining activities. Treatment can include avoiding triggers, taking pain relievers before activities that cause headaches, or in severe cases, surgery.


Are migraines more common during pregnancy and how can they be managed?

Migraines can be more common during pregnancy due to hormonal changes. Management may include identifying and avoiding triggers, using medications approved by your doctor, and implementing lifestyle changes such as stress management and regular sleep patterns.


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