title: Induction of labor at term using isosorbide mononitrate simultaneously with dinoprostone compared to dinoprostone treatment alone: a randomized, controlled trial.
abstract: OBJECTIVE
  We aimed to determine whether isosorbide mononitrate (IMN) given simultaneously with dinoprostone in term pregnancies is superior to dinoprostone alone to promote delivery.
  
  
  METHODS
  One hundred and twenty nulliparous women at term were randomly assigned to receive per vaginam IMN 40 mg or placebo in addition to 3 mg dinoprostone 2 times daily for up to 2 days. Analysis was by intention to treat.
  
  
  RESULTS
  Baseline characteristics of both groups were comparable. The induction to delivery intervals did not differ between the IMN and the placebo group (26.4 +/- 14.4 vs 23.4 +/- 14.8 hours, P = .408). IMN resulted in more headache compared to placebo (32/55 [58.2%] vs 2/55 [3.6%], P < .001).
  
  
  CONCLUSIONS
  Vaginally administered IMN does not play a role in promoting delivery in term pregnancy if given at the same time as dinoprostone. This might reflect its relaxant effect on the uterine fundus, which may overcome its cervical softening effect.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Wölfler
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchinetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Venturini
authors.forename: Ambros
authors.initials: A
authors.lastname: Huber
authors.forename: Hanns
authors.initials: H
authors.lastname: Helmer
authors.forename: Peter
authors.initials: P
authors.lastname: Husslein
authors.forename: Walter
authors.initials: W
authors.lastname: Tschugguel
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D036861:Delivery, Obstetric; D015232:Dinoprostone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007751:Labor, Induced; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D013997:Time Factors
chemical_list: D010120:Oxytocics; D007548:Isosorbide Dinitrate; D015232:Dinoprostone; C030397:isosorbide-5-mononitrate