Tension-type headache and migraine in women with threatened miscarriage: clinical and diagnostic aspects
Background. The threatened miscarriage is the most common pregnancy complication that occurs in 15–20 % of cases of ongoing pregnancy. Headache is one of the most common complaints during pregnancy; the prevalence of headaches in pregnant women reaches 35 %.The aim of this work was to study the prevalence and clinical features of tension-type headache and migraine in pregnant women with threatened miscarriage in the first and second trimesters, living in the Luhansk region, to improve treatment and prophylactic measures and prevent obstetric and perinatal complications in them. Materials and methods. The study included 84 pregnant women who were hospitalized for threatened miscarriage to the centers, located in the Luhansk region (group I). The control group consisted of 47 pregnant women with non-complicated obstetric anamnesis and physiological course of pregnancy with similar gestational period and place of residence (group II). Clinical obstetric examination was carried out, the subjective severity of headache was determined by visual analogue scale, the McGill pain questionnaire was used to characterize the headache. Results. It was found that the intensity of headache according to the visual analogue scale was Me (Q1–Q3) = 3.40 (2.90–3.78) in group I and 2.05 (1.43–3.05) in group II (p = 0.015). The intensity of migraine according to the visual analogue scale was Me (Q1–Q3) = 6.45 (4.30–7.18) and 5.15 (5.10–5.20), respectively (p = 0.533). The patients of group I more emotionally describe their headache and use more descriptors for sensory and affective characteristics of headache. In pregnant women of group I, a positive correlation was found between the age and affective characteristics of tension-type headache: the number of descriptors selected for the affective scale (r = 0.590, p = 0.002), pain rating index for the affective scale (r = 0.478, p = 0.018). Conclusions. Tension-type headaches among pregnant women with threatened miscarriage occur 1.92 more often compared to the healthy pregnant women, migraines — 1.12 times more often and make up 28.57 and 4.76 %, respectively. According to the visual analogue scale, the intensity of tension-type headache in pregnant women with threatened miscarriage was 1.66 higher than in the control group, and the severity of migraine — 1.25 times higher, the median value of tension-type headache intensity was significantly higher.
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