Comparison of isosorbide mononitrate and misoprostol for cervical ripening in termination of pregnancy between 8 and 12 weeks: a randomized controlled trial.
OBJECTIVE
The present study was undertaken to compare the efficacy of isosorbide mononitrate (IMN) and misoprostol for cervical ripening in termination of pregnancy between 8 and 12 weeks.


METHODS
This prospective randomized single blind study enrolled 40 women with singleton pregnancy seeking surgical termination of pregnancy between 8 and 12 weeks of gestation. They were divided into two groups--group I received IMN 40 mg while group II received misoprostol 40 mg vaginally, 3 h prior to suction and evacuation. All women were monitored for effects of cervical ripening and adverse effects.


RESULTS
The mean sizes of dilators that could be negotiated without any resistance was 5.9 ± 1.33 in group I and 8.6 ± 0.94 in group II (p < 0.001, 95% CI 0.58, 0.41). The mean dilator sizes at which resistance was first encountered was 6.9 ± 1.37 in group I and 9.9 ± 1.23 in group II (p < 0.001, 95% CI 0.60, 0.54). The mean blood loss was 61.5 ± 13.86 ml in group I and 36.25 ± 12.80 ml in group II (p < 0.001, 95% CI 6.07, 5.63). Headache was the most common adverse effect seen with IMN use.


CONCLUSIONS
The results show that IMN has a definite role and better safety profile than misoprostol in first trimester cervical ripening, although misoprostol is more effective and causes less blood loss.
Duhan
Nirmala
N
Department of Obstetrics and Gynecology, Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, H. No. 6/9J, Medical Campus, Rohtak 124001, Haryana, India. nkadian@gmail.com
Gupta
Sonam
S
Dahiya
Krishna
K
Sirohiwal
Daya
D
Rohilla
Seema
S
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000028:Abortion, Induced; D000282:Administration, Intravaginal; D000328:Adult; D016063:Blood Loss, Surgical; D020070:Cervical Ripening; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D007747:Labor Stage, First; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D014619:Vacuum Curettage; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate