caa a22 4500 445309059 CHVBK 20180317142623.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00404-010-1572-4 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1572-4 Intravaginal administration of isosorbide mononitrate and misoprostol for cervical ripening and induction of labour: a randomized controlled trial [Elektronische Daten] [Mohamad Abdellah, Mostafa Hussien, Ahmed AboAlhassan] Background: Labor induction in the presence of unfavorable cervix is a common indication for the use of prostaglandins. However, in the last years, there has been a considerable interest in the use of nitrous oxide donors for cervical ripening and labor induction. Objective: To evaluate the efficacy and safety of intravaginal administration of NOD isosorbide mononitrate (IMN) plus misoprostol versus misoprostol alone for cervical ripening and induction of labor. Setting: Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University. Methods: Two hundred and ninety women scheduled for labor induction were recruited and assigned randomly to IMN or placebo followed by misoprostol 50μg. The efficacy of the medication was evaluated by predetermined outcome variables for cervical ripening and induction of labor and delivery. Results: The two groups were comparable with respect to age, parity, gestational age, indication for induction, and Bishop's score. Women receiving IMN plus misoprostol showed significant changes in the Bishop score 6h after administration as compared to misoprostol plus placebo (8.57±1.46 vs. 7.6±1.39h, P=0.001), significantly shorter intervals from the beginning of the induction to the beginning of the active phase of labor (10.97±2.87 vs. 13.91±2.16h, P=0.0004) and from the beginning of induction to the time of delivery (19.56±3.96 vs. 23±2.62 P≤0.001). No significant differences in the incidence of uterine hypersystole, tachysystole and hyperstimulation. Regarding headache, much more women suffer headache in the IMN group (51) with significant difference to placebo group (11). Conclusions: Using a combination of IMN and misoprostol is more efficient than misoprostol alone in terms of fast cervical ripening and shortening of induction-labour interval. Springer-Verlag, 2010 Misoprostol nationallicence Induction nationallicence Isosorbide mononitrate nationallicence Abdellah Mohamad Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University, Assiut, Egypt aut Hussien Mostafa Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University, Assiut, Egypt aut AboAlhassan Ahmed Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University, Assiut, Egypt aut Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 25-30 0932-0067 284:1<25 2011 284 404 https://doi.org/10.1007/s00404-010-1572-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1572-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abdellah Mohamad Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University, Assiut, Egypt aut NATIONALLICENCE 700 1- Hussien Mostafa Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University, Assiut, Egypt aut NATIONALLICENCE 700 1- AboAlhassan Ahmed Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University, Assiut, Egypt aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 25-30 0932-0067 284:1<25 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer