Induction of labor at term using isosorbide mononitrate simultaneously with dinoprostone compared to dinoprostone treatment alone: a randomized, controlled trial.
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.
Wölfler
Monika M
MM
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Facchinetti
Fabio
F
Venturini
Paolo
P
Huber
Ambros
A
Helmer
Hanns
H
Husslein
Peter
P
Tschugguel
Walter
W
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
D010120:Oxytocics; D007548:Isosorbide Dinitrate; D015232:Dinoprostone; C030397:isosorbide-5-mononitrate