2-9the Use of Ibuprofen as Postpartum Analgesic in Women With Hypertensive Disorder of Pregnancy: A Systematic Review

Abstract

Background: Postpartum women are commonly prescribed with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which is effective for pain management. However, NSAIDs were known to induced hypertension. Thus, the use of NSAIDs in postpartum women with hypertension is still controversial due to a lack of evidence. This study aims to identify the use of ibuprofen as postpartum analgesics in women with hypertensive disorder of pregnancy. Methods: A systematic literature search was conducted using specific keywords with medical subheading (MeSH) terms on PubMed, EBSCOhost, Cochrane, and ProQuest for primary studies published from January 2009 – December 2019. Two authors independently screened and assessed the potential studies using inclusion criteria. The quality of the randomized controlled trial studies was assessed with JADAD scale and Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the quality of cohort studies. Result: After screening the literature, four randomized controlled trials (RCTs) and two retrospective cohort studies were identified, comprising of 895 total patients. All studies except one RCT showed that ibuprofen did not increase postpartum blood pressure in postpartum women with hypertensive disorders of pregnancy compared with women without the exposure of NSAIDs. Those who were receiving ibuprofen showed no difference in postpartum mean arterial pressure (MAP) compared to control. No significant adverse events were also found in postpartum women. Discussion: This review demonstrates that the use of ibuprofen may be beneficial and can be used for postpartum women with hypertension. However, further studies with a larger population are still needed to confirm these results.