Preeclampsia And Nonsteroidal Drugs for Analgesia: a Randomized Non Inferiority Trial

Inclusion Criteria: * Women at \> 23 weeks gestational age undergoing vaginal or cesarean delivery at Barnes-Jewish Hospital with: * An antepartum diagnosis of preeclampsia with severe features * Pre-eclampsia with severe features will be defined as: * Elevated blood pressure ≥ 160/110, or * Pre-eclampsia in the setting of thrombocytopenia (platelet count \< 100,000), or * Impaired liver function (AST elevated to twice upper limit of normal), or * Persistent epigastric pain, or * Renal insufficiency (serum creatinine of 1.1 mg/dl or doubling of prior value), or * Pulmonary edema, or * New onset visual disturbance or headache unresponsive to therapy. Exclusion Criteria: * NSAID allergy * Allergy to acetaminophen * Antihypertensive use in this pregnancy prior to 20 weeks gestation * Chronic kidney disease or Acute kidney injury with Creatine clearance less than 60 mL/min * Inability to obtain consent * Opioid abuse disorder * Peptic ulcer disease.