Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Ibuprofen vs Acetaminophen in Postpartum Hypertension

Am J Obstet Gynecol; ePub 2018 Mar 2; Blue, et al

The first-line use of ibuprofen rather than acetaminophen for postpartum pain did not lengthen the duration of severe-range hypertension in women with preeclampsia with severe features, a recent study found. At delivery, women with preeclampsia with severe features were randomized to receive around-the-clock oral dosing with either 600 mg of ibuprofen or 650 mg of acetaminophen every 6 hours. Dosing began within 6 hours after delivery and continued until discharge. The primary outcome was the duration of severe-range hypertension. Among the findings:

  • 154 women were assessed for eligibility; 100 met criteria.
  • There were no differences in baseline characteristics between groups.
  • There was no difference in the duration of severe-range hypertension in the ibuprofen vs acetaminophen groups (35.3 vs 38.0 hours).
  • There were no differences between groups in the secondary outcome measures of time from delivery to last blood pressure ≥150/100 mm Hg, postpartum mean arterial pressure, maximum postpartum systolic or diastolic blood pressures, any postpartum blood pressure ≥160/110 mm Hg, short-acting antihypertensive use for acute blood pressure control, length of postpartum stay, need to extend postpartum stay for blood pressure control, antihypertensive use at discharge, or opioid use for inadequate pain control.


Blue NR, Murray-Krezan C, Drake-Lavelle S, et al. Effect of ibuprofen vs acetaminophen on postpartum hypertension in preeclampsia with severe features: a double-masked, randomized controlled trial. [Published online ahead of print March 2, 2018]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2018.02.016.

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