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Isosorbide mononitrate or misoprostol for cervical ripening in missed pregnacies during first trimester

Abstract:

Objective: To compare the effects of isosorbide mononitrate and misoprostol for cervical ripening in interrupted pregnancies during the first trimester. Methods: Patients were randomly assigned to receive 40. mg of isosorbide mononitrate (group A) or 200. mcg of misoprostol (group B) vaginally. The efficacy rate, time between treatment start and cervical ripening, and adverse effects were evaluated. Results: There were no statistically significant differences in the general characteristics between the two groups (p=ns). The time between treatment start and cervical ripening was shorter in group B than in group A, but this difference was not significant (p=ns). The percentage of patients with a successfully ripened cervix within 24. h of treatment was similar in the two groups (p=ns). The frequency of patients with headache was higher in group A than in group B (p<0.05). Conclusion: Isosorbide mononitrate has similar effects to misoprostol in cervical ripening in interrupted pregnancies during the first trimester but the frequency of headache is significantly higher in patients receiving isosorbide mononitrate. © 2009 Elsevier España, S.L.