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Evaluation of isosorbide mononitrate for cervical ripening prior to induction of labor for postdated pregnancy in an outpatient setting
Author(s) -
Agarwal Kavita,
Batra Aruna,
Batra Achla,
Dabral Anjali,
Aggarwal Abha
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.04.017
Subject(s) - medicine , labor induction , placebo , bishop score , pregnancy , adverse effect , oxytocin , outpatient clinic , isosorbide mononitrate , anesthesia , obstetrics , cervix , alternative medicine , pathology , cancer , biology , genetics
Objective To determine the safety and effectiveness of self‐administered treatment with isosorbide mononitrate (IMN) for cervical ripening in Indian women with postdated pregnancies. Methods A randomized, placebo‐controlled study was conducted with 200 women with postdated pregnancies and unfavorable cervices who self‐administered vaginally either 2 40‐mg tablets of IMN or 2 40‐mg tablets of pyridoxine as placebo prior to admission for induction of labor. The main outcome variables were change in Bishop score, time from admission to delivery, and presence or absence of fetal and maternal morbidity. Results The Bishop score was significantly improved 24 hours after initiation of the outpatient IMN treatment ( P < 0.001) and the needs for further cervical ripening and oxytocin infusion were less in the study than in the control group ( P < 0.001 and P = 0.008). The time from admission to delivery was also less ( P < 0.001). Moreover, the IMN treatment had no major adverse maternal or fetal effects. The vast majority of women in both groups were either satisfied or very satisfied with the outpatient treatment. Conclusion The self‐administration, at home, of isosorbide mononitrate leads to a safe and effective cervical ripening prior to labor induction in women with postdated pregnancies. CTRI Registration No.: CTRI/2011/091/000121