BACKGROUND AND PURPOSE:

• Penfield et al. (Obstetrics & Gynecology, 2019) studied the effect of ibuprofen on BP in the setting of hypertensive disorders of pregnancy immediately postpartum

METHODS:

• Double-blind randomized controlled trial (RCT)
  • Hypertension in Postpartum Preeclampsia Study (HIPPS)
• Participants
  • Diagnosis of hypertensive disorders of pregnancy and mild range BPs (i.e., not requiring antihypertensive meds) prior to randomization
  • Women with other severe features and eclampsia were included
  • Exclusion included chronic hypertension and contraindications to the use of the study medication (ibuprofen or acetaminophen)
• Groups (randomized in the immediate postpartum period)
  • Ibuprofen: 600 mg orally every 6 hours
  • Acetaminophen: 650 mg orally every 6 hours
• Sample size needed
  • 56 participants were needed to detect a difference of 6 mm Hg in average mean arterial pressure between the study groups
• Primary outcome
  • Average mean arterial pressure during the postpartum hospital stay
• Secondary outcomes
  • Use of breakthrough opioid pain medications
  • Length of hospital stay
  • Postpartum diuresis: Urine output ≥200 mL/hour for 4 hours
• First outpatient BP within 10 days of discharge was also recorded

RESULTS:

• 31 women in ibuprofen group | 30 women in the acetaminophen group
• Postpartum average arterial pressure did not differ between groups (p=0.93)
  • Ibuprofen group: 93±8 mm Hg
  • Acetaminophen group: 93±7 mm Hg
• No difference in
  • Breakthrough opioid pain medication requests (p=0.62)
    • Ibuprofen group: 24%
    • Acetaminophen group: 30%
  • Length of hospital stay (p=0.06)
    • Ibuprofen group: 48 hours
    • Acetaminophen group: 43 hours
  • Rate of postpartum diuresis (p=0.2)
    • Ibuprofen group: 61 %
    • Acetaminophen group: 77%

CONCLUSION:

• The authors conclude that

… our results suggest that NSAIDs do not increase blood pressure in postpartum women with hypertensive disorders of pregnancy without severe hypertension

Learn More – Primary Sources:

Ibuprofen and Postpartum Blood Pressure in Women With Hypertensive Disorders of Pregnancy: A Randomized Controlled Trial

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