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

Related ObG Topics:

Does Ibuprofen Increase the Risk for Postpartum Hypertension in the Setting of Preeclampsia?

What is the Best Analgesia Protocol for Use After Cesarean?

Are NSAIDs Associated with Persistent Postpartum Hypertension in Women with Preeclampsia?