Analgesics and Anti-inflammatory Prescription for Pregnant Women, Military and Khartoum Teaching Hospitals, Khartoum, Sudan, 2016

Abstract

Background: Pregnancy loss, preterm delivery and maternal illness are all made more likely by active rheumatic, musculoskeletal, fever, and pain conditions. Pregnant women endure a range of aches and pains, and the majority of them can be treated without the use of analgesics/anti-inflammatory drugs. Many of these drugs are accessible over the counter. Some analgesic treatments may be teratogenic or fetotoxic in pregnancy.

Aim: This study aims to provide information on the analgesics and anti-inflammatory prescription to pregnant women and to correlate the prescriptions to women’s characteristics including their medical history, in Khartoum, Sudan.

Methods: The study was a descriptive cross-sectional hospital-based study conducted at the Military and Khartoum Teaching Hospitals in Khartoum State. A data collection form designed by the researcher was used to obtain information on pregnant women from records during the period from January 2015 to January 2016. Women's characteristics, their medical history and the prescriptions for different types of analgesics and anti-inflammatory drugs were extracted. The Chi-square test was used and a p-value < 0.05 was judged statistically significant when analyzing the data using SPSS version 16.

Results:The records of 650 expectant mothers were reviewed. Analgesic and anti-inflammatory medications were prescribed to 63 (9.7%) of the women. Of those women, 53 (84%) were in their third trimester; p=0.0001. Therapeutic agents used were: acetylsalicylic acid (aspirin) used in 39 (61.9%) of this group; followed by dexamethasone in 15 (23.8%); diclofenac sodium in 5 (7.9%), mefnamic acid in 2 (3.2%), and acetaminophen (paracetamol) in 2 (3.2%). The rate of prescription of Analgesic/anti-inflammatory drugs during pregnancy in this study is comparable to international literature.    Acetylsalicylic acid (aspirin) was used in low doses (81 – 100 mg). Indications for using low dose aspirin (LDA) in this group were, Systemic hypertension (n=24; 61.5%); venous thromboembolism (n=7; 17.9%); hypertension-during-pregnancy (n=4; 10.2%); diabetic mellitus (n=2; 5.1%) and congenital hyperadrenalism (n=2; 5.1%).

Conclusions: In this study, various analgesics and anti-inflammatory drugs were used to treat minor to moderate pain, headaches and/or fever during pregnancy at a prescription rate comparable to the international literature. Although studies have shown that analgesic and anti-inflammatory medications can be safely taken during pregnancy, they should be under the supervision of qualified physicians and pharmacists for the appropriateness of the treatment and to avoid drug-related problems.