J Matern Fetal Neonatal Med. 2016 Jul 7:1-15. [Epub ahead of print]

Ibuprofen versus acetaminophen as a post-partum analgesic for women with severe pre-eclampsia: Randomized clinical study.

Vigil-De Gracia P¹, Solis V¹, Ortega N¹.

Abstract

OBJECTIVE:

To compare differences in blood pressure levels between patients with severe post-partum pre-eclampsia using ibuprofen or acetaminophen.

METHODS:

A randomized controlled trial was made in women with severe pre-eclampsia or superimposed pre-eclampsia after vaginal birth. The patient was randomly selected to receive either 400 mg of ibuprofen every 8 hours or 1 g of acetaminophen every 6 hours during the post-partum. The primary variable was systolic hypertension ≥ 150 mmHg and/or diastolic hypertension ≥ 100 mmHg after the first 24 hours post-partum. Secondary variables were the arterial blood pressure readings at 24, 48, 72, and 96 hours post-partum and maternal complications.

RESULTS:

113 patients were studied: 56 in the acetaminophen group and 57 in the ibuprofen group. With regard to the primary variable significantly more cases there was in the ibuprofen group (36/57; 63.1%) that in the acetaminophen group, (16/56; 28.6%). Severe hypertension (≥ 160/110 mmHg) was not significantly different between the groups, 14.5% (acetaminophen) and 24.5% (ibuprofen). The levels of arterial blood pressure show a hammock-shaped curve independent of the drug used, however is more noticeable with ibuprofen.

CONCLUSIONS:

This study show that ibuprofen significantly elevates blood pressure in women with severe pre-eclampsia during the post-partum period.