Comparison of isosorbide mononitrate and misoprostol for cervical ripening in termination of pregnancy between 8 and 12 weeks: a randomized controlled trial
Duhan, N.; Gupta, S.; Dahiya, K.; Sirohiwal, D.; Rohilla, S.
Archives of Gynecology and Obstetrics 283(6): 1245-1248
2011
ISSN/ISBN: 1432-0711 PMID: 20549511 DOI: 10.1007/s00404-010-1535-9Document Number: 224057
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. 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. 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. 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.
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