Examination of pregnant and lactating mothers with headaches

Examination of pregnant and lactating mothers with headaches

The basic principles of examination for headache are used in women during pregnancy and lactation. Do not postpone the examination until delivery or termination of breastfeeding. It should include a detailed history, physical examination and all necessary laboratory diagnostic methods.

Differential diagnosis should be carried out with eclampsia, thrombosis, benign intracranial hypertension (formerly called pseudotumor of the brain), growing pituitary adenoma or meningiomas.

Radiodiagnosis for headaches in pregnant and lactating mothers

Radiodiagnosis of diseases of the cervical spine is usually carried out only after childbirth, and treatment tactics is determined on the basis of the results of studies conducted during pregnancy. If necessary, x-ray diagnostics to reduce the radiation effect on the fetus, the pelvic area must be screened. Neuroimaging is recommended for those patients in whom the data of anamnesis and objective examination suggest the presence of neurological pathology, and the results of the study may affect the tactics of treatment during pregnancy. MRI is preferred in the study of patients who have undergone TBI in general, and in pregnant and lactating women as well.

The American College of Radiology recommends MRI examinations for pregnant women who are contraindicated for ionizing radiation, and the use of imaging techniques is necessary in order to determine further management tactics. In general, the use of MRI during pregnancy is considered safe and does not adversely affect the fetus.

Proof of this are studies of the condition of three-year-olds whose mothers were exposed to the survey, as well as female staff who conducted the MRI examination.

The need for CT may occur in some women with neurological disorders or headaches suggesting the possibility of intracranial hemorrhage. The degree of influence on the fetus depends on the duration of the study and on the dose of radiation. In general, the effect of radiation on the fetus is negligible (<0.005 mGy) – below the level that has a damaging effect on the fetus.

It is believed that the risk of negative effects of radiation on the fetus is significantly lower than the consequences of a serious neurological disease not diagnosed in a mother in a timely manner.

At the XI European Symposium on Urogenital Pathology, an analysis of a wide range of literature data on the use of iodine-containing contrast media and gadolinium during pregnancy and lactation was presented and recommendations were formulated for their use during this period.

During the examination, iodine contrast from the mother’s body is able to suppress the function of the thyroid gland of the fetus and newborn; in such cases, newborns need a screening examination of thyroid function. There is no reliable information about the effect of gadolinium contrast on the fetus. Iodine or gadolinium contrast agents are found in breast milk only in small quantities; therefore, to stop breastfeeding when using them is not recommended.

local_offerevent_note December 17, 2018

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