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Created on : 22 Dec 2003
Modified on : 25 Jun 2018

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Bibliographical entry (without author) :

Randomized trial of isosorbide mononitrate versus misoprostol for cervical ripening at term. Int J Gynaecol Obstet. 2002 Aug;78(2):139-45.

Author(s) :

Chanrachakul B, Herabutya Y, Punyavachira P.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVES: To assess the adverse effects of isosorbide mononitrate (IMN) compared with misoprostol for cervical ripening at term.

METHODS: One hundred and seven women with term pregnancies referred for induction of labor with Bishop scores of 6 or less were randomly allocated to receive either a 40-mg IMN tablet vaginally (n = 55) or 50 microg misoprostol vaginally (n = 52) every 6 h for a maximum of three doses. They were sent to the labor ward for amniotomy or oxytocin if either their Bishop scores were more than 6 or their cervices were not ripe 24 h after the treatment. Adverse effects, progress, and outcomes of labor were assessed.

RESULTS: Isosorbide mononitrate was associated with fewer adverse effects especially uterine tachysystole (0 vs. 19.2%, P < 0.01) and hyperstimulation (0 vs. 15.4%, P < 0.01). The time from start of medication to vaginal delivery in IMN group was significantly longer (25.6 +/- 6.1 vs. 14 +/- 6.9 h, P < 0.01). Oxytocin was needed in 51 women (92%) of the isosorbide mononitrate group and six women (11%) of the misoprostol group (P < 0.001). The cesarean rate was not significantly different between the groups, but the major indications were different: dystocia (45%) in the IMN group vs. persistent non-reassuring fetal heart rate pattern (56%) in the misoprostol group.

CONCLUSIONS: Cervical ripening with IMN resulted in fewer adverse effects, but was less effective than misoprostol.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Comparaison de l’efficacité et des effets secondaires du mononitrate isosorbide et du misoprostol pour la maturation du col

Argument (English):

Comparison of efficacy and side effects of isosorbide mononitrate and misoprostol for cervical ripening

Argumento (português):

Comparação da eficácia e efeitos colaterais do mononitrato de isossorbida e misoprostol para o amadurecimento cervical

Argumento (español):

Keywords :

➡ c-section/caesarean ; evidence-based medicine/midwifery ; physiology ; hormones ; amniotomy ; active management of labor ; oxytocin ; rupture of membranes ; induction of labor ; ripening of cervix ; post-term pregnancy ; fetal distress ; dystocy ; misoprostol (Cytotec)

Author of this record :

Cécile Loup — 22 Dec 2003
➡ latest update : Bernard Bel — 25 Jun 2018

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