Preinduction cervical ripening using oral and vaginal isosorbide dinitrate in patients with term pregnancy : A randomized clinical trial

authors:

avatar Somayeh Moukhah , * , avatar firoozeh ahmadi

Koomesh: Vol.17, issue 4; 863-870
published online: September 28, 2016
article type: Research Article
received: May 01, 2015
accepted: April 02, 2016

how to cite: Moukhah S, ahmadi F. Preinduction cervical ripening using oral and vaginal isosorbide dinitrate in patients with term pregnancy : A randomized clinical trial. koomesh. 2016;17(4):e151178. 

Abstract

Introduction: Cervical ripening in labor is one of the most important objects in midwifery. Isosorbide dinitrate (ISDN) is one of the most important agents, which has been proposed for cervical ripening, but there are still controversies regarding its prescription. The present study aimed to assess the effects of vaginal and oral ISDN for preinduction cervical ripening. Materials and Methods: In this non-blinded clinical trial, 99 nulliparous women with term or prolonged pregnancy were selected and were randomly divided into two groups by block randomization. The intervention groups included those received vaginal ISDN (n=50, 40 mg, daily) and oral ISDN (n=49, 20 mg, twice daily). Size of ripening was measured by bishop score before treatment and 24 hours after that. Results: 24 hours after treatment, bishop score was significantly increased (P < 0.001)in both the vaginal and oral ISDN groups. Both groups were compared regarding the pregnancy termination and cesarean causes, and no significant difference was found between them (P > 0.05).  Duration of induction to the second phase of delivery was compared in two groups.  Although there was not any significant difference between the two groups in terms of shifting time from the active phase to delivery and duration of the second phase (P > 0.05), there was a meaningful difference between two groups in duration from induction to the active phase of delivery (P < 0.001). Also shifting time from induction to the active phase of delivery in vaginal ISDN group was shorter than oral ISDN group (3.7 hour versus 4.8 hour). Conclusion: Prescribing vaginal ISDN for cervical ripening was more effective than oral medication, and it seems to be with minimum side effects.

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