scholarly journals Isosorbide Mononitrate and Misoprostol for Cervical Ripening in Induction of Labor

2016 ◽  
Vol 1 (1) ◽  
pp. 8-12
Author(s):  
Mohamad Elsokary
Keyword(s):  
Induction Of Labor ◽  
Cervical Ripening ◽  
Isosorbide Mononitrate

scholarly journals Effect of Isosorbide Mononitrate and Misoprostol for Cervical Ripening in Induction of Labor

2021 ◽  
Vol 83 (1) ◽  
pp. 862-868
Author(s):  
Moustafa Abbas Ibrahim ◽  
Hussein Mohammed Abdel Dayem ◽  
Amr Ahmed Abdelrhman ◽  
Doaa Hamed Abo El-Khir
Keyword(s):  
Induction Of Labor ◽  
Cervical Ripening ◽  
Isosorbide Mononitrate

scholarly journals Comparison of Isosorbide Mononitrate Versus Misoprostol in Cervical Ripening at Term Before Induction of Labor: A Clinical Trial

2018 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Marzieh Lotfalizade ◽  
Nayereh Khadem Ghaebi ◽  
Farideh Golhasani Keshtan ◽  
Vida Taghipour Bazargani
Keyword(s):  
Clinical Trial ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Isosorbide Mononitrate

Intravaginal isosorbide mononitrate in addition to misoprostol versus misoprostol only for induction of labor: a randomized controlled trial

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Harb ◽  
D Y Mansour ◽  
Y M A M E Abouahmed
Keyword(s):  
Nitric Oxide ◽  
Clinical Trial ◽  
Active Phase ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Isosorbide Mononitrate ◽  
Nitric Oxide Donors ◽  
P Value ◽  
Delivery Time ◽  
Whole Process

Abstract Background Induction of labor is still a controversial obstetric procedure. The need to shorten delivery time has been recognized and practiced for centuries. Although the indications have clearly changed during the past decades from a need to expel a dead fetus to an effective solution to reduce the threat to the mother and her precious fetus, effective and safe methods of achieving delivery must always have been the primary objectives. Induction is indicated when the benefits to either mother or fetus outweigh those of pregnancy continuation. Nitric oxide donors(NO donors) such as isosorbide mononitrate could be of a great use for cervical ripening because of their effect on release of prostaglandins and vasodilation while having no or little effect on uterine activity ; since they are relatively safe and has low number of non-vital adverse effect if used with caution, they could be added to misoprostol to shorten to time needed for cervical ripening thus accelerating the whole process of induction of labor. The Aim of this study was to evaluate safety & efficacy of nitric oxide donors such as intravaginal isosorbide mononitrate in addition to misoprostol versus misoprostol only for the whole process of induction of labor. Patients and Methods in a prospective randomized double-blind placebo-controlled clinical trial which was conducted at Ain Shams Maternity University Hospital in Cairo from January 2018 to June 2018, 50 women were included in induction of labor, they were randomly divided into 2 group: Group I consisted of 25 patients, each patient was given 1 tablet of isosorbide mononitrate 40mg vaginally once and one tablet of misoprostol 25mcg vaginally; Group II consisted of 25 patients, each patient was given 1 tablet of misoprostol 25mcg vaginally. Misoprostol were given for a maximum of 5 doses (one 25mcg vaginal tablet) with interval of 6 hours between each tablet. This clinical trial was registered in clinicaltrial.gov registry with number: NCT03523754. Results there was a statistically significant difference between Isosorbide mononitrate & Misoprostol group versus Misoprostol only group regarding induction to delivery time ( mean 19.55 ± 1.41 to 22.94 ± 1.44 hours respectively, P-value <0.001) , induction to active phase interval (mean 10.67 ± 1.83 to 13.81 ± 0.52 hours respectively, P-value <0.001), maternal headache (36% to 12% respectively, P-value =0.047). Conclusion Isosorbide mononitrate appears to be a safe agent when used with misoprostol for induction of labor. It decreases induction to delivery time and induction to active phase time.

scholarly journals Vaginal administration of isosorbide mononitrate for cervical ripening prior to induction of labor for postdated pregnancy: a randomized controlled trial

2018 ◽  
Vol 1 (1) ◽  
pp. 51-58
Author(s):  
Rubina Rai ◽  
P Basnet ◽  
A Thakur ◽  
T Pradhan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Controlled Trial ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Isosorbide Mononitrate ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Unfavorable Cervix

 Introduction: Induction of labor is commonly practiced intervention in modern Obstetrics. The aim of induction of labor is to initiate labor when maternal and fetal conditions necessitate delivery before the onset of spontaneous contraction with purpose to achieve safe vaginal delivery. Induction of labor is one of the most commonly practiced interventions in the Department of Obstetrics and Gynecology every day. The success of this obstetric practice is highly dependent upon the condition of the cervix which is assessed with Bishop‟s Score and it is well known that unfavorable cervix is associated with failure of induction and cesarean section. In the recent years, there has been a considerable interest in the use of nitrous oxide donors for cervical ripening and labor induction.Objective: To evaluate whether isosorbide mononitrate administered vaginally prior to induction in postdated pregnancy is effective for pre-induction cervical ripening and thus, improves the process of induction of labor.Methods: One hundred and twenty women scheduled for labor induction were recruited and assigned randomly to isosorbide mononitrate or placebo followed by misoprostol 25μg. The efficacy of the medication was evaluated by predetermined outcome variables for cervical ripening and induction of labor and delivery.Results: The groups were comparable with respect to age, gestational age and Bishop‟s score. Women receiving isosorbide with misoprostol didn‟t show any improvement in the Bishop‟s score compared to misoprostol and placebo. There was no significant difference between the two groups regarding time of delivery and onset of active stage of labor from induction. Cesarean delivery rates were similar between the two groups; however, the indications of the cesarean section were different between the two groups which were significant statistically. Neonatal outcome were similar between the two groups.Conclusion: The addition of vaginal isosorbide mononitrate to oral misoprostol for cervical ripening and labor induction did not reduce time to vaginal delivery and didn‟t help in improving pre-induction cervical score.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, page: 51-58

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