Randomised trial of nitric oxide donor versus prostaglandin for cervical ripening before first-trimester termination of pregnancy

Vaginal administration of the nitric oxide donor isosorbide mononitrate can induce effective ripening of the human cervix. We investigated whether this drug is associated with fewer side-effects than prostaglandins when used to ripen the cervix before first-trimester surgical termination of pregnanc...

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Bibliographic Details
Published in:The Lancet (British edition) 1998-10, Vol.352 (9134), p.1093-1096
Main Authors: Thomson, Andrew J, Lunan, C Burnett, Ledingham, Marieanne, Howat, Robert CL, Cameron, Iain T, Greer, Ian A, Norman, Jane E
Format: Article
Language:English
Subjects:
Abortifacient Agents, Nonsteroidal - adverse effects
Abortifacient Agents, Nonsteroidal - therapeutic use
Abortion
Abortion, Induced
Adult
Alprostadil - adverse effects
Alprostadil - analogs & derivatives
Alprostadil - therapeutic use
Biological and medical sciences
Blood
Cervical Ripening - drug effects
Clinical trials
Dose-Response Relationship, Drug
Drugs
Female
Genital system. Reproduction
Humans
Isosorbide Dinitrate - administration & dosage
Isosorbide Dinitrate - adverse effects
Isosorbide Dinitrate - analogs & derivatives
Isosorbide Dinitrate - therapeutic use
Medical procedures
Medical sciences
Nitric oxide
Nitric Oxide Donors - administration & dosage
Nitric Oxide Donors - adverse effects
Nitric Oxide Donors - therapeutic use
Pharmacology. Drug treatments
Pregnancy
Pregnancy Trimester, First
Side effects
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Summary:Vaginal administration of the nitric oxide donor isosorbide mononitrate can induce effective ripening of the human cervix. We investigated whether this drug is associated with fewer side-effects than prostaglandins when used to ripen the cervix before first-trimester surgical termination of pregnancy, and assessed whether the extent of cervical ripening it induces is clinically sufficient. 66 primigravid women scheduled for surgical termination were assigned to receive before surgery, per vaginam, isosorbide mononitrate 40 mg or 80 mg, or the prostaglandin analogue gemeprost 1 mg. The primary measured outcome was onset of new symptoms before termination of pregnancy. More women remained symptom-free after isosorbide mononitrate than after gemeprost (28/44 [64%] vs 3/22 [14%], p
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(98)01289-6