Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial
ObjectiveTo determine whether vaginal application of 40 mg isosorbide-5-mononitrate (ISMN) has a comparable cervical ripening efficacy to and lesser side effects than 400 µg misoprostol in women scheduled for the first trimester induced abortion using a manual vacuum aspirator (MVA).MethodsWe conduc...
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| Format: | Article |
| Language: | English |
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Korean Society of Obstetrics and Gynecology
2019-09-01
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| Series: | Obstetrics & Gynecology Science |
| Subjects: | |
| Online Access: | http://ogscience.org/upload/pdf/ogs-62-313.pdf |
| _version_ | 1818991629244039168 |
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| author | Aloke Kumar De Bhattacharyya Sanjoy Kumar Aparna Chakraborty Amrita Samanta |
| author_facet | Aloke Kumar De Bhattacharyya Sanjoy Kumar Aparna Chakraborty Amrita Samanta |
| author_sort | Aloke Kumar De |
| collection | DOAJ |
| description | ObjectiveTo determine whether vaginal application of 40 mg isosorbide-5-mononitrate (ISMN) has a comparable cervical ripening efficacy to and lesser side effects than 400 µg misoprostol in women scheduled for the first trimester induced abortion using a manual vacuum aspirator (MVA).MethodsWe conducted a prospective randomized open-label study in 70 women at 6–12 weeks of pregnancy at the R G Kar Medical College and Hospital, Kolkata, India, over a period of two years from 2015 to 2017. Forty milligrams of ISMN and 400 µg misoprostol were vaginally applied for cervical priming. The primary outcome measure was the cervical response assessed by the passage of the appropriate and largest sized MVA cannula through the internal os without resistance, at the beginning of the procedure.ResultsThe base line cervical dilatation was found to be significantly higher in the misoprostol group than in the ISMN group (7.65±1.38 vs. 6.9±1.26 mm; P=0.025, 95% confidence interval, −1.4046 to −0.953). However, when the women were sub-analyzed based on parity, there was no statistically significant difference in the same parameters among the multigravid women. The need for further cervical dilatation was significantly higher in the ISMN group when the primigravid women were compared, although the multigravid women responded favorably to ISMN.ConclusionIn the primigravid women, misoprostol appears to exert a higher efficacy as a cervical ripening agent in contrast to ISMN. However, ISMN can be used in multigravid women for the same purpose as in this group, misoprostol did not show any significant improvement in efficacy over ISMN. |
| first_indexed | 2024-12-20T20:13:18Z |
| format | Article |
| id | doaj.art-cfc1a7aa89e543eba8772c51ca2e4451 |
| institution | Directory Open Access Journal |
| issn | 2287-8572 2287-8580 |
| language | English |
| last_indexed | 2024-12-20T20:13:18Z |
| publishDate | 2019-09-01 |
| publisher | Korean Society of Obstetrics and Gynecology |
| record_format | Article |
| series | Obstetrics & Gynecology Science |
| spelling | doaj.art-cfc1a7aa89e543eba8772c51ca2e44512022-12-21T19:27:46ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85722287-85802019-09-0162531332110.5468/ogs.2019.62.5.313592Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trialAloke Kumar De0Bhattacharyya Sanjoy Kumar1Aparna Chakraborty2Amrita Samanta3Department of Gynecology and Obstetrics, R G Kar Medical College, Kolkata, West Bengal, .IndiaDepartment of Gynecology and Obstetrics, R G Kar Medical College, Kolkata, West Bengal, .IndiaDepartment of Gynecology and Obstetrics, R G Kar Medical College, Kolkata, West Bengal, .IndiaDepartment of Community Medicine, R G Kar Medical College, Kolkata, West Bengal, .IndiaObjectiveTo determine whether vaginal application of 40 mg isosorbide-5-mononitrate (ISMN) has a comparable cervical ripening efficacy to and lesser side effects than 400 µg misoprostol in women scheduled for the first trimester induced abortion using a manual vacuum aspirator (MVA).MethodsWe conducted a prospective randomized open-label study in 70 women at 6–12 weeks of pregnancy at the R G Kar Medical College and Hospital, Kolkata, India, over a period of two years from 2015 to 2017. Forty milligrams of ISMN and 400 µg misoprostol were vaginally applied for cervical priming. The primary outcome measure was the cervical response assessed by the passage of the appropriate and largest sized MVA cannula through the internal os without resistance, at the beginning of the procedure.ResultsThe base line cervical dilatation was found to be significantly higher in the misoprostol group than in the ISMN group (7.65±1.38 vs. 6.9±1.26 mm; P=0.025, 95% confidence interval, −1.4046 to −0.953). However, when the women were sub-analyzed based on parity, there was no statistically significant difference in the same parameters among the multigravid women. The need for further cervical dilatation was significantly higher in the ISMN group when the primigravid women were compared, although the multigravid women responded favorably to ISMN.ConclusionIn the primigravid women, misoprostol appears to exert a higher efficacy as a cervical ripening agent in contrast to ISMN. However, ISMN can be used in multigravid women for the same purpose as in this group, misoprostol did not show any significant improvement in efficacy over ISMN.http://ogscience.org/upload/pdf/ogs-62-313.pdfcervical ripeningisosorbide-5-mononitrateinduced abortion |
| spellingShingle | Aloke Kumar De Bhattacharyya Sanjoy Kumar Aparna Chakraborty Amrita Samanta Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial Obstetrics & Gynecology Science cervical ripening isosorbide-5-mononitrate induced abortion |
| title | Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial |
| title_full | Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial |
| title_fullStr | Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial |
| title_full_unstemmed | Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial |
| title_short | Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial |
| title_sort | evaluation of isosorbide 5 mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol a randomized controlled trial |
| topic | cervical ripening isosorbide-5-mononitrate induced abortion |
| url | http://ogscience.org/upload/pdf/ogs-62-313.pdf |
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