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Federación Mexicana de Ginecología y Obstetricia, A.C.

2011, Number 05

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Ginecol Obstet Mex 2011; 79 (05)

Comparison of isosorbide dinitrate and dinoprostone for induction of labor in termpregnancy

Romero-Gutiérrez G, Bernal GOE, Ponce-Ponce LAL

Language: Spanish
References: 17
Page: 285-291
PDF size: 299.07 Kb.


ABSTRACT

Background: it has been suggested that nitric oxide generators, such as isosorbide dinitrate, may be an alternative to mimic the effects of signal transduction mechanisms leading to cervical ripening, without affecting uterine contractility
Objective: to compare the isosorbide dinitrate and dinoprostone for induction of labor in term pregnancy.
Material and methods: in a randomized controlled blinded clinical trial, we studied 66 patients divided into 2 groups: 33 patients were given 20 mg of isosorbide dinitrate and to the other 33 were administered 0.5 mcg of dinoprostone; in both groups the drugs were administered vaginally each 6 h and at maximum 3 times. It was carried out a cardiotocographic study in order to determine the presence or absence of uterine activity and to exclude disorders of the fetal hearth frequency; it was performed a vaginal examination to assess cervical conditions determining the Bishop score at 0, 6 and 12 h.
Results: there were no differences between the groups in the determinations of mean arterial pressure, maternal hearth frequency, fetal hearth frequency and Bishop score registered at 6 y 12 h followed the drugs administration. The time of delivery was 20.7 ± 1.8 h in the group of women treated with dinoprostone; and 16.3 ± 1.4 h in women treated with isosorbide dinitrate (p=0.032). The cost was higher in women treated with dinoprostone ($560 vs $12, respectively, p=0.001). There was no difference between the groups related to: frequency of meconium stained liquid (p=1.000), mode of delivery by caesarean section (p=0.918), Apgar score at 1 minute (p=0.764) and 5 minutes (p=0.294) and mother discharged with healthy baby (p=1.000).
Conclusions: the isosorbide dinitrate is associated with lower duration of labor compared with dinoprostone. There was no difference in the maternal-fetal outcome by using whatever drug.


REFERENCES

  1. de Pace V, Chiosi G, Facchinetti F. Clinical use of nitric oxide donors and L-arginine in obstetrics. J Matern Fetal Neonatal Med 2007;20:569-579.

  2. Osmers RG, Adelmann-Grill BC, Rath W, Stuhlsatz HW, Kunn W. Biochemical events in cervical ripening dilatation during pregnancy and parturition. J Obstet Gynaecol (Tokyo) 1995;21:185-194.

  3. Trachtman H, Futtrweit S, Singhal P. Nitric oxide modulates the synthesis of extracellular matrix proteins in cultured rat mesangial cells. Biochem Biophys Res Commun 1995;6:120-125.

  4. Rath WH. Outpatient induction-how safe. J Perinat Med 2009;37:461-467.

  5. Wolfler MM, Faccinetti F, Venturini P, Huber A, et al. Induction of labor at term using isosorbide mononitrate simultaneously with dinoprostone compared to dinoprostone treatment alone: a randomized, controlled trial. Am J Obstet Gynecol 2006;195:1617-1622.

  6. Bollapragada SS, MacKenzie F, Norrie JD, Eddama O, et al. Randomised placebo-controlled trial of outpatient (at home) cervical ripening with isosorbide mononitrate (IMN) prior to induction of labor - clinical trial with analyses of efficacy and acceptability. The IMOP study. BJOG 2009;116:1185-1195.

  7. Osman I, MacKenzie F, Norrie J, Murray HM, et al. The “PRIM” study: a randomized comparison of prostaglandin E2 gel with the nitric oxide donor isosorbide mononitrate for cervical ripening before the induction of labor at term. Am J Obstet Gynecol 2006;194:1012-1021.

  8. Eddama O, Petrou S, Schroeder L, Bollapragada SS, et al. The cost-effectiveness of outpatient (at home) cervical ripening with isosorbide mononitrate prior to induction of labour. BJOG 2009;116:1196-1203.

  9. Ekerhovd E, Bullarbo M, Andersch B, Norstrom A. Vaginal administration of the nitric oxide donor isosorbide mononitrate for cervical ripening at term: a randomized controlled study. Am J Obstet Gynecol 2003;189:1692-1697.

  10. Habib SM, Emam SS, Saber AS. Outpatient cervical ripening with nitric oxide donor isosorbide mononitrate prior to induction of labor. Int J Gynaecol Obstet 2008;101:57-61.

  11. Rameez MF, Goonewardene IM. Nitric oxide donor isosorbide mononitrate for pre-induction cervical ripening at 41 weeks’ gestation: A randomized controlled trial. J Obstet Gynaecol Res 2007;33:452-456.

  12. Bullarbo M, Orrskog ME, Andersch B, Granstrom L, et al. Outpatient vaginal administration of the nitric oxide donor isosorbide mononitrate for cervical ripening and labor induction postterm: a randomized controlled study. Am J Obstet Gynecol 2007;196:50.e 1-5.

  13. Abdellah MS, Hussien M, Aboalhassan A. Intravaginal administration of isosorbide mononitrate and misoprostol for cervical ripening and induction of labour: a randomized controlled trial. Arch Gynecol Obstet 2010 Jun 26 (Epub ahead of print).

  14. Nicoll AE, Mackenzie F, Greer IA, Norman JE. Vaginal application of the nitric oxide donor isosorbide mononitrate for preinduction cervical ripening: a randomized controlled trial to determine effects on maternal and fetal hemodynamics. Am J Obstet Gynecol 2001;184:958-964.




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