Oral Paracetamol versus oral Diclofenac in the control of uterine cramping pain after vaginal birth



  • Olufemi Aworinde Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Ogbomoso


uterine cramp, after-pain, postpartum analgesia, Diclofenac and Paracetamol


Background: Uterine cramping pain is a documented morbidity in the immediate postpartum period but there is no protocol yet, for its management. The study aims to compare the efficacy of multiple doses of oral paracetamol and diclofenac in the control of uterine cramping pain in women that had spontaneous vaginal delivery

Methods: It is a randomized controlled trial among 291 women that had spontaneous vaginal delivery at LAUTECH Teaching Hospital Ogbomoso. They were recruited in the labour ward and randomized into Paracetamol, Diclofenac or Placebo group. Initial pain intensity was assessed followed by administration of the drugs within 1hour of delivery and then 8hourly until 24 hours. The instrument of survey was a proforma and data was analyzed using SPSS 22. Primary outcome measures were adequacy of pain relief, onset of breastfeeding and maternal satisfaction. Secondary outcome was potential maternal side effects of the drugs.

Results: The incidence of after-pain was found to be 100% with a large proportion (97.9%) being severe. Respondents’ age, gestational age, duration of labour and oxytocin augmentation of labour correlated significantly with severity of pain. Diclofenac was significantly better than paracetamol which in turn was better than placebo in relieving the pain, mean SPID- 8.71 [SD-1.17; CI-8.48-8.95], 6.78 [SD-2.25; CI-6.33-7.24] and 1.54[SD-1.35, CI-1.26-1.31], F-487.31; p< 0.001 for diclofenac, paracetamol and placebo respectively. Maternal side effects were seen only in diclofenac group.

Conclusion: Multiple doses of oral Diclofenac and Paracetamol were efficacious in relieving uterine cramping after-pain although more with diclofenac.



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Original Article