A comparison of isosorbide mononitrate, misoprostol and combination therapy for preinduction cervical ripening at term : a randomized controlled trial
Joint Authors
Sanad, Zakariyya
Ubayd, Usamah Muhammad
Source
Tanta Medical Sciences Journal
Issue
Vol. 1, Issue 4 (31 Dec. 2006), pp.69-82, 14 p.
Publisher
Tanta Medical Sciences Society
Publication Date
2006-12-31
Country of Publication
Egypt
No. of Pages
14
Main Subjects
Topics
Abstract EN
Aim : the purpose of this study was to compare the efficacy, safety, and acceptability of isosorbide mononitrate (IMN), misoprostol, and the combination therapy for cervical ripening before induction of labor at term.
Patients and Methods : A prospective, double-blind, placebo-controlled, randomized clinical trial in 196 term and post-term nulliparous women with unfavorable cervices who were assigned randomly to receive either 40mg of IMN (n = 65), 50p.g of misoprostol (n = 65), or both of them (n = 66) in the posterior vaginal fornix.
Changes in Bishop score and cervical length, progress and outcomes of labor and adverse effects were assessed.
Results : the combination therapy was more effective than IMN or misoprostol.
Successful induction (vaginal delivery within 24 h of initiation of cervical ripening) was significantly higher in the misoprostol (60 %) and combination therapy (62.1 %) groups compared with the IMN (27.7 %) group (P < 0.0001).
Mean duration (h) from treatment initiation to delivery was greater for IMN (26.7 + 7.5) than misoprostol (16.5 + 6.7) and combination therapy (14.8 + 6.2) groups (P < 0.0001).
Oxytocin was needed more in the IMN group (93.8 %) than in the misoprostol (21.5 %) and combination therapy (25.8 %) groups (P < 0.0001).
IMN was safer and more acceptable than misoprostol and combination therapy.
The cesarean rate was not significantly different among groups, but the major indications were different : dystocia (54.5 %) in the IMN group versus persistent non-reassuring FHR pattern (57.9 %) in the misoprostol and (47.6 %) in the combination therapy groups (P = 0.01).
Conclusion : the combination therapy was more effective than either IMN or misoprostol alone for preinduction cervical ripening at term.
However, IMN was safer, well tolerated and more acceptable.
American Psychological Association (APA)
Sanad, Zakariyya& Ubayd, Usamah Muhammad. 2006. A comparison of isosorbide mononitrate, misoprostol and combination therapy for preinduction cervical ripening at term : a randomized controlled trial. Tanta Medical Sciences Journal،Vol. 1, no. 4, pp.69-82.
https://search.emarefa.net/detail/BIM-277583
Modern Language Association (MLA)
Sanad, Zakariyya& Ubayd, Usamah Muhammad. A comparison of isosorbide mononitrate, misoprostol and combination therapy for preinduction cervical ripening at term : a randomized controlled trial. Tanta Medical Sciences Journal Vol. 1, no. 4 (Dec. 2006), pp.69-82.
https://search.emarefa.net/detail/BIM-277583
American Medical Association (AMA)
Sanad, Zakariyya& Ubayd, Usamah Muhammad. A comparison of isosorbide mononitrate, misoprostol and combination therapy for preinduction cervical ripening at term : a randomized controlled trial. Tanta Medical Sciences Journal. 2006. Vol. 1, no. 4, pp.69-82.
https://search.emarefa.net/detail/BIM-277583
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 81-82
Record ID
BIM-277583