Outpatient vaginal administration of the nitric oxide donor isosorbide mononitrate for cervical ripening and labor induction postterm: a randomized controlled study

Objective Our aim was to examine the efficacy, safety, and acceptability of isosorbide mononitrate for cervical ripening and labor induction in women in an outpatient setting. Study design Two hundred pregnant women of at least 42 weeks’ gestation with an unripe cervix were randomly selected to rece...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2007, Vol.196 (1), p.50.e1-50.e5
Main Authors: Bullarbo, Maria, MD, Orrskog, Monica Eriksson, MD, Andersch, Björn, MD, PhD, Granström, Lena, MD, PhD, Norström, Anders, MD, PhD, Ekerhovd, Erling, MD, PhD
Format: Article
Language:English
Subjects:
Administration, Intravaginal
Adult
Ambulatory Care
Biological and medical sciences
cervical ripening
Cervical Ripening - drug effects
Delivery. Postpartum. Lactation
Diseases of mother, fetus and pregnancy
Double-Blind Method
Female
Gynecology. Andrology. Obstetrics
Humans
induction of labor
Isosorbide Dinitrate - administration & dosage
Isosorbide Dinitrate - analogs & derivatives
isosorbide mononitrate
Labor, Induced - methods
Medical sciences
nitric oxide
Nitric Oxide Donors - administration & dosage
Obstetrics and Gynecology
Pregnancy
Pregnancy, Prolonged - drug therapy
Pregnancy. Fetus. Placenta
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Summary:Objective Our aim was to examine the efficacy, safety, and acceptability of isosorbide mononitrate for cervical ripening and labor induction in women in an outpatient setting. Study design Two hundred pregnant women of at least 42 weeks’ gestation with an unripe cervix were randomly selected to receive vaginally either 40 mg isosorbide mononitrate or placebo tablets. Results Twenty-two women treated with isosorbide mononitrate went into labor within 24 hours compared to 8 women in the placebo group ( P < .05). In women who did not go into labor, cervical status was similar in the 2 groups the next day. Headache was a common side effect. No maternal or fetal side effects of clinical importance were registered. Conclusion Outpatient cervical ripening and labor induction with isosorbide mononitrate seems to be an effective, safe, and well tolerated procedure. The definitive clinical efficacy and safety needs to be evaluated in larger series of patients.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2006.08.034