What should you know about sudden severe headache pregnancy?

Headache in pregnancy can be linked with dehydration, missed meals, poor sleep, heat, stress, a cold or sinus congestion. Allergic Rhinitis, Chronic Sinusitis and Common Cold can produce pressure or facial discomfort, while COVID-19 may add fever, cough or body aches. Anxiety can intensify pain and muscle tension. Dengue Fever and Heat Exhaustion are also relevant possibilities in the right setting, particularly after travel, heat exposure or contact with illness.

A sudden, severe or unfamiliar headache deserves a different level of attention from a familiar mild headache. Pregnancy-related blood-pressure problems can present with headache and visual symptoms, so the timing, severity and accompanying signs matter.

Stop activity, rest somewhere cool and drink fluids if you can keep them down. Note when the pain began, where it is, how quickly it peaked, and any fever, visual change, abdominal pain or swelling. Contact your maternity team or urgent medical service promptly for a severe or unusual headache. Take only pain relief that your pregnancy clinician has said is suitable; avoid borrowing someone else’s medicine.

Seek emergency help immediately for a thunderclap headache, fainting, confusion, seizure, weakness, trouble speaking, stiff neck, severe vomiting, loss of vision, chest pain or difficulty breathing. Prompt assessment is also needed for severe headache with facial or hand swelling, upper abdominal pain or a known raised blood pressure. Do not drive yourself if you feel faint or neurologically unwell.

Could my blood pressure, hydration, infection or medication explain this? Do I need urine or blood tests, observation, or a change in pregnancy-safe treatment? Which symptoms should make me return immediately?