title: Nitric oxide donors induce ripening of the human uterine cervix: a randomised controlled trial.
abstract: OBJECTIVE
  To determine whether nitric oxide donors can induce cervical ripening before surgical termination of pregnancy in the first trimester.
  
  
  METHODS
  Prospective, randomised controlled trial.
  
  
  METHODS
  Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow.
  
  
  METHODS
  Forty-eight primigravid women undergoing surgical termination of pregnancy before 12 weeks of gestation.
  
  
  METHODS
  The women were randomised to receive per vaginam before surgery either the nitric oxide donor isosorbide mononitrate, the nitric oxide donor glyceryl trinitrate, the prostaglandin analogue gemeprost, or no treatment.
  
  
  METHODS
  The cumulative force required to dilate the cervix to 8 mm was measured objectively and the cervical diameter before surgical dilatation was recorded.
  
  
  RESULTS
  Following isosorbide mononitrate or gemeprost, a lower cumulative force was required to dilate the cervix to 8 mm and a higher cervical diameter before dilatation was recorded. Pretreatment with glyceryl trinitrate reduced the cumulative force required to dilate the cervix but had no effect on cervical diameter.
  
  
  CONCLUSIONS
  Like the prostaglandin analogue gemeprost, the nitric oxide donors isosorbide mononitrate and glyceryl trinitrate can effect cervical ripening. Nitric oxide donors may provide an alternative to prostaglandins for cervical ripening before surgical procedures in the first trimester.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Glasgow.
authors.forename: A J
authors.initials: AJ
authors.lastname: Thomson
authors.forename: C B
authors.initials: CB
authors.lastname: Lunan
authors.forename: A D
authors.initials: AD
authors.lastname: Cameron
authors.forename: I T
authors.initials: IT
authors.lastname: Cameron
authors.forename: I A
authors.initials: IA
authors.lastname: Greer
authors.forename: J E
authors.initials: JE
authors.lastname: Norman
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000328:Adult; D000527:Alprostadil / Q000031:analogs & derivatives; D002584:Cervix Uteri / Q000187:drug effects*; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000031:analogs & derivatives / Q000627:therapeutic use; D009569:Nitric Oxide / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D009569:Nitric Oxide; C021182:gemeprost; D000527:Alprostadil; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate