TITLE:
Use of Nitric Oxide Donor Isosorbide Mononitrate for Cervical Ripening at 41 Weeks’ Gestation
AUTHORS:
Mohamed Elmahdy, Hesham Galal, Amany El Marsafawi, Nahla Amin
KEYWORDS:
Cervical Ripening, Nitric Oxide Donor, IMN
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.8,
July
5,
2016
ABSTRACT: Background: The ideal agent for cervical ripening would induce adequate
cervical ripening with minimal adverse effects to the
mother and the fetus; the most favorable method for cervical ripening is not
fully agreed till now; however, vaginal administration of isosorbide
mononitrate (IMN) is considered a low-risk method of labor induction for post
term. Our study was designed to assess the effect of IMN on cervical ripening
and labor induction among 41 weeks pregnant women. Objectives: To assess the
efficacy of the nitric oxide donor isosorbide mononitrate on cervical ripening
at 41 weeks gestation. Materials and Methods: This study was conducted on 100
pregnant women recruited from the outpatient clinic fulfilling the inclusion
criteria. Cases were divided into 2 groups. In first group 40 mg isosorbide
mononitrate (IMN) tablet was applied vaginally in posterior fornix, and in
second group placebo was applied vaginally in posterior fornix. Following up
the cervical status after 24 hours of administration, the patient were asked
about new symptoms especially headache, palpitation, dizziness or abdominal
pain and the mode of delivery was assessed. Results: There was a significant
improvement in the bishop score in the first group rather than the placebo
group. No significant difference between the two groups was as regards the mode
of delivery. Conclusion: IMN may be used for cervical preparation only before
induction of labor in post term cases.