Are NSAIDs Associated with Persistent Postpartum Hypertension in Women with Preeclampsia?
In nonpregnant women, NSAIDs are associated with increased systolic and diastolic BPs in patients with chronic hypertension
Research on the effect of NSAIDs in pregnancy in women with preeclampsia is currently inconclusive
Viteri et al. (Obstetrics & Gynecology, 2017) sought to determine whether NSAIDs increase BP in women with severe preeclampsia
Retrospective cohort study (2013 – 2015)
Women included were those with severe preeclampsia who remained hypertensive for greater than 24 hours
NSAID use included either ibuprofen or ketorolac
Persistent postpartum hypertension
Systolic blood pressure 150 mm Hg or greater or diastolic 100 mm Hg or greater (or both), on two occasions, at least 4 hours apart
Severe maternal morbidity: pulmonary edema, renal dysfunction, stroke, eclampsia, NICU admission, length of postpartum hospital stay, receipt of narcotics, and hospital readmission
Of the 399 women had severe preeclampsia and 324 (81%) remained hypertensive 24 hours postpartum
When comparing women who received NSAIDs vs those who did not
There was no difference in persistent postpartum hypertension when comparing women who received NSAIDs (70%) vs those who did not (73%)
There were no differences in BP based on labetalol or nifedipine use
There were no differences in the rate of narcotic use (89% vs 75%) or other secondary outcomes
NSAIDs are not associated with increased risk of persistent postpartum hypertension
There were no differences in narcotic use but the authors suggest that may be related to the fact that the majority of women underwent cesarean section and would be exposed to stronger pain medications
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