Isosorbide mononitrate appears to be an efficacious, well tolerated therapy for cervical ripening and labour induction in post-term pregnancy,

2007 ◽  
Vol &NA; (1578) ◽  
pp. 15
Author(s):  
&NA;
Keyword(s):  
Cervical Ripening ◽  
Labour Induction ◽  
Isosorbide Mononitrate ◽  
Term Pregnancy ◽  
Post Term Pregnancy

scholarly journals Indications of Labor Induction at Delivery Room of Maternity Teaching Hospital in Erbil City

2021 ◽  
Vol 4 (1) ◽  
pp. 41-19
Author(s):  
Bewar Noori ◽  
◽  
Awaz Saeed ◽  
Keyword(s):  
Antenatal Care ◽  
Teaching Hospital ◽  
Gestational Hypertension ◽  
Delivery Room ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Chronic Hypertension ◽  
Term Pregnancy ◽  
Significant Difference ◽  
Post Term Pregnancy

Background and objectives: Induction of labour means stimulation of contractions before the birth starts spontaneously, with or without ruptured membranes. The most common indications include oligohydramnios, pre-labour rupture of the membranes, high blood pressure during pregnancy, severe fetal growth restriction, post-term pregnancy, and var-ious maternal medical conditions such as chronic hypertension and diabetes. The aim of the study was to find out the different indications of labour and associated obstetrical factors in a local tertiary hospital. Methods: A cross-sectional study was conducted among 120 parturient women who attended a delivery room in the Maternity Teaching Hospital in Erbil City from the period of 2nd June to 2nd October 2020. After reviewing the literature, a questionnaire was pre-pared to obtain socio-demographic data, data related to reproductive characteristic and data related to the indications for labour induction. The data were analyzed using descrip-tive and inferential statistical approaches. Results: The study included 120 patients with the highest percentage of the patients (49.1%) were 16 to 23 years old and more than half of the sample (51.6%) had a post-term pregnancy, gestational hypertension and pre-eclampsia (15%). There were highly significant statistical differences between parity, gestational age and indication of labour induction, and significant differences between gravidity and antenatal care visits and indi-cations for labour induction. Conclusions: The majority of the sample had a post-term pregnancy of 40 and 42 weeks as an indication for induction of labour followed by gestational hypertension and pre-eclampsia, oligohydramnios and pre-labour rupture of membrane. There was a statistical-ly significant difference between the antenatal care visit and parity with the induction of labour.

scholarly journals Intravaginal Administration Of Misoprostol Alone Versus Misoprostol And Isosorbidemononitrate For Cervical Ripening And Labour Induction

2017 ◽  
Vol 2 (1) ◽  
pp. 37
Author(s):  
Nasreen Noor ◽  
Ambhika Sharma ◽  
Shazia Parveen ◽  
Syed Manazir Ali
Keyword(s):  
Neonatal Outcome ◽  
Active Phase ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Isosorbide Mononitrate ◽  
Group I ◽  
Uterine Hyperstimulation ◽  
Posterior Fornix ◽  
Intravaginal Administration ◽  
Phase Interval

ABSTRACTOBJECTIVES: To compare the efficacy and safety of intravaginal administration of misoprostol  alone versus misoprostol and  isosorbide mononitrate for cervical ripening and labour induction.MATERIAL AND METHODS: One hundred women with term gestation,  Bishop  score <4 with various indications for labour induction were randomly divided into two groups. In Group I, 50 µg of misoprostol tablet was placed intravaginally, 4 hourly maximum upto 4 doses. In Group II,50 µg of misoprostol tablet with 40mg of isosorbide mononitrate was placed intravaginally in posterior fornix upto 4 doses.RESULTS: Two groups were similar in their clinical characteristics. The induction to delivery interval  was 20.8±2.9 hours vs 14.2±2.7 hours in two groups respectively. Misoprostol and isosorbide mononitrate was associated with a shorter induction to delivery interval, decreased oxytocin requirement higher rate of  vaginal delivery i.e 62.8% Vs 53.9% . Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups.CONCLUSION: The present study suggests that both intravaginal misoprostol and combination of isosorbide mononitrate and misoprostol are safe and effective modes of labour induction. Isosorbide mononitrate and misoprostol is more effective than misoprostol alone in terms of  shorter induction to active phase interval and induction to delivery interval.   

scholarly journals A comparative study of safety and efficacy of vaginal isosorbide mononitrate (40mg) with dinoprostone gel (0.5mg)

2018 ◽  
Vol 7 (10) ◽  
pp. 4197
Author(s):  
Malathi T. M. ◽  
Kanchanamalai K.
Keyword(s):  
Side Effects ◽  
Cost Effective ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Isosorbide Mononitrate ◽  
Control Group ◽  
Study Group ◽  
Safety And Efficacy

Background: It is essential to intervene pregnancy for safety of mother, fetus or both. Successful labor induction is clearly related to the state of the cervix. Women with an unfavorable cervix who have not experienced cervical ripening phase before labor present the greatest challenge with regard to labor induction. Therefore, it is necessary to use optimal technique for cervical ripening and safe confinement. One of the common methods includes use of PGE2 gel for cervical ripening. The rationale of this study is to compare the safety and efficacy of Iso-sorbide mononitrate as pre-induction cervical ripening with PGE2 gel induction.Methods: After attaining ethics approval [PSG IHEC], a prospective randomised, case-controlled study was conducted on 182 women undergoing elective induction of labour. They were allocated to either Study or Control group by computer generated random number table method. ISMN was used vaginally prior to labour induction in the study group whereas PGE2 gel induction was used in the control group. Change in bishop score and Induction to delivery interval was assessed in both the groups.Results: There was a significant reduction in induction to delivery interval in the study group (ISMN) 15.2 hours when compared to 23.2 hours in the control group (PGE2 gel) with p=0.000. Need for augmentation of labour was reduced in the study group significantly with p=0.003. Cost of induction was less when compared to the control group. ISMN had less side effects hence can be used as OP basis.Conclusions: Vaginal Isosorbide mononitrate when used as a cervical ripening agent significantly reduces induction to delivery interval. Use of Isosorbide mononitrate was associated with very less side effects and it is a cost-effective drug. Thus, ISMN can be used safely and effectively in term patients for pre-induction cervical ripening when compared to PGE2 gel.

scholarly journals Randomized Comparison of Isosorbide Mononitrate and PGE2 Gel for Cervical Ripening at Term including High Risk Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kavita Agarwal ◽  
Achla Batra ◽  
Aruna Batra ◽  
Abha Aggarwal
Keyword(s):  
High Risk ◽  
Adverse Effects ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Isosorbide Mononitrate ◽  
Bishop Score ◽  
Risk Pregnancy ◽  
To Receive

Aims. Prostaglandin E2 is the most commonly used drug for cervical ripening prior to labour induction. However, there are concerns regarding uterine tachysystole and nonreassuring fetal heart (N-RFH). Isosorbide mononitrate (IMN) has been used successfully for cervical ripening. The present study was conducted to compare the two drugs for cervical ripening at term in hospital.Methods. Two hundred women with term pregnancies referred for induction of labour with Bishop score less than 6 were randomly allocated to receive either 40 mg IMN tablet vaginally (n=100) or 0.5 mg PGE2 gel intracervically (n=100). Adverse effects, progress, and outcomes of labour were assessed.Results. PGE2 group had significantly higher postripening mean Bishop score, shorter time from start of medication to vaginal delivery (13.37 ± 10.67 hours versus 30.78 ± 17.29 hours), and shorter labour-delivery interval compared to IMN group (4.53 ± 3.97 hours versus 7.34 ± 5.51 hours). However, PGE2 group also had significantly higher incidence of uterine tachysystole (15%) and N-RFH (11%) compared to none in IMN group, as well as higher caesarean section rate (27% versus 17%).Conclusions. Cervical ripening with IMN was less effective than PGE2 but resulted in fewer adverse effects and was safer especially in high risk pregnancies.

scholarly journals POST TERM PREGNANCY;

2017 ◽  
Vol 24 (04) ◽  
pp. 500-506
Author(s):  
Uzma Shahzad ◽  
Uzma Manzoor ◽  
Nadia Awais ◽  
Tasneem Azher
Keyword(s):  
Caesarean Section ◽  
Well Being ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Term Pregnancy ◽  
Prolonged Pregnancy ◽  
Group 3 ◽  
Group 2 ◽  
Study Setting ◽  
Post Term Pregnancy

Post term pregnancy is used to describe pregnancy that continues for 294 days ormore following the first day of last menstrual period. Post term pregnancy has been consideredto occur in 10-20 % of all pregnancies. PGE2 have been used vaginally for induction of labourfor the last two decades. Routine induction of labour after 41 weeks gestation appears to reduceperinatal mortality. Objectives: The study was done to: 1) To calculate the induction – deliverytime with prostaglandins E2 in prolonged pregnancy. 2) To find frequency of normal vaginaldelivery versus caesarean section after induction with prostaglandins E2. Study design: It wasdescriptive study. Setting: It was study of fifty patients carried out in Gynae unit 1 Allied HospitalFaisalabad. Period: 03 March 2005 to 02 March 2006. Subjects: Inclusion Criteria: 1) Allpatients with prolonged pregnancy of more than forty two weeks were included. 2-Only singletonpregnancies were included. Exclusion criteria: 1-Patients who had previous caesarean sectionwere excluded from the study. 2) Patients who had associated obstetric condition that modify themode of delivery were excluded. Data collection procedure: Detailed history and examinationwas carried out with availability of dating ultrasound to ascertain dates. Bishop score assessed.Tests of foetal well being carried out. After informed consent induction of labour carried out withprostin E2, and effect studied on induction – onset and delivery intervals and mode of delivery.Results: Induction onset interval was 3.5 hours in Primigravida, was 2.8 hours in group 2(G2 &G3) and 2.0 hours in group 3(G4 & more). Induction delivery interval was 18 hours in group 1,14 hours in group 2 and 10-12 hours in group 3. Mean percentage of normal vaginal deliverywas 78.5% in all groups. Forceps delivery was 5.6% and caesarean section was 15.7%. Numberof patients successfully induced was 84.2% Conclusion: The study confirmed the efficacy ofPGE2 tablets in achieving cervical ripening. It was also seen to decrease induction deliveryinterval more so in multigravida.

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