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Órgano de difusión oficial del Instituto Materno Infantil del Estado de México

2015, Number 2

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Arch Inv Mat Inf 2015; 7 (2)

Effect of isosorbide mononitrate at cervical level, for induction of labor in patients with term pregnancy

Becerra MEA, Ramírez LG

Language: Spanish
References: 24
Page: 47-53
PDF size: 100.22 Kb.


ABSTRACT

Introduction: Cervical ripening refers to the softening of the cervix as a necessary anatomical feature for the progression of labor. The most common drugs for this are synthetic prostaglandins such as misoprostol. In recent years the use of nitric oxide donors drugs reported as facilitators of cervical ripening has become important. The nitric oxide donors increases the proinflammatory state and induce the production of F2a prostaglandins. Objective: To determine the efficacy of isosorbide mononitrate in the induction of labor with term pregnancy in the Hospital of Gynecology and Obstetrics of Mother and Child Institute of the State of Mexico. Material and methods: Observational, prospective and descriptive study with cohort design. Patients chosen between September 1 and December 31, 2014 with initial Bishop less than six points, term pregnancy and first time pregnant from the Emergency and Hospitalization Department were included. To each patient was applied isosorbide mononitrate 20, 40 and 60 mg vaginally every eight hours with a vaginal examination, upon application, to determine current Bishop index. Results: 25 patients were included. The average age was 19.9 years. 72% had an initial Bishop index higher than nine points. All of them with term pregnancy. 20% of patients showed a cervical ripening with 20 mg of isosorbide mononitrate. The route of resolution by childbirth delivery occurs in 68% of patients. Conclusions: The resulting cervical ripening after use of isosorbide mononitrate is adequate and raises the score of Bishop index, according to the results of this study, obtaining a greater number of vaginal deliveries.


REFERENCES

  1. Myers KM, Paskaleva AP, Huose M, Socrate S. Mechanical and biochemical properties of human cervical tissue, Acta Biomater, 2008; 4 (1): 104-116.

  2. Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A et al. The length of the cervix and the risk of spontaneous premature delivery, N Engl J Med, 1996; 334 (9): 567-572.

  3. Owen J, Yost N, Berghella V, Thom E, Swain M, Dildy GA 3rd et al. Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth, JAMA, 2001; 286 (11): 1340-1348.

  4. Word RA, Li XH, Hnat M, Carrick K. Dynamics of cervical remodeling during pregnancy and parturition: mechanisms and current concepts, Semi Reprod Med, 2007; 25 (1): 69-79.

  5. Read CP, Word RA, Ruscheinsky MA, Timmons BC, Mahndroo MS. Cervical remodeling during pregnancy and parturition: molecular characterization of the softening phase in mice, Reproduction, 2007; 134 (2): 327-340.

  6. Sennström MB, Ekman G, Westergren-Thorsson G, Malmström A, Bryström B, Endrésen et al. Human cervical ripening, an inflammatory process mediated by cytokines, Mol Hum Reprod, 2000; 6 (4): 375-381.

  7. Bishop EH. Pelvic scoring for elective induction, Obstet Gynecol, 1964; 24: 266-268.

  8. Szczesny W, Kjøllesdal M, Karlsson B, Nielsen S. Bishop score and the outcome of labor induction with misoprostol, Acta Obstet Gynecol Scand, 2006; 85 (5): 579-582.

  9. Keirse MJ. Prostaglandins in pre-induction cervical ripening. Meta-analysis of worldwide clinical experience. J Reprod Med, 1993; 38 (1 Suppl.): 89-100.

  10. McCarthy FP, Kenny LC. Induction of labor: review, Obstet Gynecol Rep Med, 2010; 21 (1): 1-6.

  11. Consejo de Salubridad General, Guía de Práctica Clínica SS-218-09. Inducción del trabajo de parto en el segundo nivel de atención. México, 2012. URL Disponible en: http://www.cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/218_SSA_09_TDP/GPC_218-09_Induccion_Trabajo_de_PartoEVR.pdf

  12. Mandruzzato G, Alfirevic, Chervenak A, Heinonen S, Levene M, Salvesen K et al. Guidelines for the management of post-term pregnancy, J Perinat Med, 2010; 38 (2): 111-119.

  13. Gülmezoglu AM, Crowther CA, Middleton P, Heatley E. Induction of labor for improving birth outcomes for women at or beyond term, Cochrane Database Syst Rev, 2012; 6: CD004945. doi: 10.1002/14651857.CD004945.pub3.

  14. Norman J. Nitric oxide and the myometrium, Pharmacol Ther, 1996; 70 (2): 91-100.

  15. Bullarbo M, Orrskog ME, Andersch B, Granström L, Norström A, Ekerhovd E. Outpatient vaginal administration of the nitric oxide donor isosorbide mononitrate for cervical ripening and labor induction post-term: a randomized controlled study, Am J Obstet Gynecol, 2007; 196 (1): 50.e1-5.

  16. Chanrachakul B, Herabutya Y, Punyavachira P. Potential efficacy of nitric oxide for cervical ripening in pregnancy at term, Int J Gynecol Obstet, 2000; 71 (3): 217-219.

  17. Chanrachakul B, Herabutya Y, Punyavachira P. Randomized comparison of glyceryl trinitrate and prostaglandin E2 for cervical ripening at term, Obstet Gynecol, 2000; 96 (4): 549-553.

  18. Chanrachakul B, Herabutya Y, Punyavachira P. Randomized trial of isosorbide mononitrate versus misoprostol for cervical ripening at term, Int J Gynecol Obstet, 2002; 78 (2): 139-145.

  19. Sharma Y, Kumar S, Mittal S, Misra R, Dadhwal V. Evaluation of glyceryl trinitrate, misoprostol, and prostaglandin E2 gel for pre-induction cervical ripening in term pregnancy, J Obstet Gynaecol Res, 2005; 31 (3): 210-215.

  20. Habib SM, Emam SS, Saber AS. Outpatient cervical ripening with nitric oxide donor isosorbide mononitrate prior to induction of labor, Int J Gynecol Obstet, 2008; 101 (1): 57-61.

  21. Bollapragada SS, MacKenzie F, Norrie JD, Eddama O, Petrou S, Reid M et al. Randomised placebo-controlled trial of outpatient (at home) cervical ripening with isosorbide mononitrate (IMN) prior to induction of labour–clinical trial with analyses of efficacy and acceptability. The IMOP study, BJOG, 2009; 116 (9): 1185-1195.

  22. Agarwal K, Batra A, Batra A, Dabrai A, Agganwal A. Evaluation of isosorbide mononitrate for cervical ripening prior to induction of labor for postdated pregnancy in an outpatient setting, Int J Gynecol Obstetr, 2012; 118 (3): 205-209.

  23. Bates CD, Nicoll AE, Mullen AB, Mackenzie F, Thomson AJ, Norman JE. Serum profile of isosorbide mononitrate after vaginal administration in the third trimester, BJOG, 2003; 110 (1): 64-67.

  24. Romero-Gutiérrez G, Bernal GOE, Ponce-Ponce de León AL. Isosorbide y dinoprostona en inducción del trabajo de parto, Ginecol Obstet Mex, 2011; 79 (5): 285-291.




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