History of Migraine and Increased Risk of Preeclampsia

A 27 year old primigravida with a history of chronic severe migraine with aura, admitted to hospital at 34 weeks’ gestation for a severe migraine episode not responsive to treatment, suddenly developed an extremely severe, lifethreatening form of preeclampsia complicated by HELLP (Haemolysis, Elevated Liver enzymes and Low Platelet count) syndrome and acute fetal damage. The patient experienced relief of migraine during the first trimester of pregnancy, and reappearance and progressive worsening of the episodes in the second half of pregnancy. It is suggested that the disappearance of recurrent migraine episodes is a protective factor against the risk of developing pregnancy complications, particularly preeclampsia, while the lack of improvement seems to increase the risk of developing preeclampsia. Pregnant patients with migraine should be included in high-risk protocols of care.