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• W4244278768 abstract "To test the hypothesis that non-steroidal anti-inflammatory drugs, such as ibuprofen, adversely affect postpartum blood pressure (BP) control in women with preeclampsia with severe features. We approached women with preeclampsia with severe features to receive postpartum “around-the-clock” oral dosing with either 600mg of ibuprofen or 650mg of acetaminophen every 6 hours, with randomization occurring at delivery. Dosing began within 6 hours after delivery and continued until discharge, with opioid analgesics available PRN for breakthrough pain. Patients, nurses and physicians were masked to study allocation. Exclusion criteria were serum AST or ALT > 200mg/dL, serum creatinine >1.0mg/dL, infectious hepatitis, gastroesophageal reflux disease, age < 18 years, or current incarceration. Our primary outcome was the time required to achieve BP control, defined as the time (in hours, h) from delivery to the last BP ≥ 160/110. In order to have 80% power to detect a difference of 24 hours between study arms with alpha set at 0.05, 46 women in each arm were needed. Secondary outcomes were time from delivery to last BP ≥ 150/105, mean arterial pressure (MAP), need for antihypertensive medication at discharge, prolongation of hospital stay for BP control, postpartum use of short-acting antihypertensives for acute BP control, and opioid use for breakthrough pain. We analyzed all outcome data according to intention-to-treat principles. One hundred women were randomized to receive regular postpartum dosing of ibuprofen or acetaminophen. Eight patients crossed over, and 92 completed the study protocol in their assigned groups. We found no differences in baseline characteristics between groups. We did not find a difference in the time to BP control in the ibuprofen versus acetaminophen groups (35.3h vs 38.0h, p=0.30). There were also no differences between groups in the need for antihypertensive medication at discharge, need to extend hospital stay for BP control, MAP, opioid use for insufficient pain control, or need for short-acting antihypertensives for acute BP control. The first-line use of ibuprofen rather than acetaminophen for postpartum pain did not lengthen the time to BP control in women with preeclampsia with severe features.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W4244278768 date "2018-01-01" @default.
• W4244278768 modified "2023-10-18" @default.
• W4244278768 title "LB04: Effect of Ibuprofen versus acetaminophen on postpartum hypertension in preeclampsia with severe features: a double-masked, randomized controlled trial" @default.
• W4244278768 doi "https://doi.org/10.1016/j.ajog.2017.11.599" @default.
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