title: Can isosorbide mononitrate be useful in second trimester termination of pregnancies?
abstract: BACKGROUND
  Isosorbide mononitrate (IMN) administration is thought to enhance in the cervical ripening process. We sought to identify the clinical usefulness and safety of IMN administration for shortening the time to termination of the second trimester pregnancy procedures when used in addition to misoprostol.
  
  
  METHODS
  Women were randomly selected to receive either the standard misoprostol treatment (control group) or, additionally, receive vaginally IMN as well as the misoprostol treatment.
  
  
  RESULTS
  The mean induction to complete abortion interval was 20.4 h [95% confidence interval (CI)=16.63-24.17] in the misoprostol group compared with 12.4 h (95% CI=10.33-14.47) in the misoprostol plus IMN group. This difference was statistically significant (p<.05). In the subgroups of nulliparas and multiparas, the shortening effect of the IMN was also statistically significant.
  
  
  CONCLUSIONS
  A net benefit after the combined use of IMN and misoprostol was noted. Therefore, we believe that IMN has a clinical role in the ripening process.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, University of Athens, Athens, Greece. thanasism@yahoo.com
authors.forename: Athanasios
authors.initials: A
authors.lastname: Mousiolis
authors.forename: Mihalis
authors.initials: M
authors.lastname: Sindos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects; D000025:Abortion, Eugenic; D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006115:Greece; D006771:Hospitals, Maternity; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016595:Misoprostol / Q000008:administration & dosage; D020030:Nitric Oxide Donors / Q000008:administration & dosage / Q000009:adverse effects; D010298:Parity; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013607:Tablets; D013997:Time Factors
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D020030:Nitric Oxide Donors; D013607:Tablets; D016595:Misoprostol; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate