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Vaginal isosorbide mononitrate or misoprostol for cervical ripening in term pregnancies

Abstract:

Objective: To compare the effectiveness of vaginal isosorbide mononitrate or misoprostol in cervical ripening in term pregnancies. Methods: Patients undergoing cervical ripening and induction of labor were selected and randomly assigned to receive 40 mg isosorbide mononitrate (group A) or 100 mcg misoprostol (group B). The efficacy rate, time between cervical ripening and delivery, neonatal outcome and adverse effects were evaluated. Results: There were no significant differences between the groups in general characteristics (p=ns). Patients treated with misoprostol showed a shorter period from first dose administration to newborn delivery than those treated with isosorbide (p<0.05). There were no significant differences in the number of vaginal births between the two groups (p=ns). Newborns in group B had significantly lower mean Apgar scores at 1 and 5 min than those in group A (p<0.05). The most common adverse effect in group A was headache (16 cases, 53.3%) and diarrhea (five cases, 16.7%) in group B. Conclusion: The effectiveness of vaginal misoprostol and isosorbide mononitrate is similar in cervical ripening in term pregnancy. © 2009 Elsevier España, S.L. All rights reserved.