Effectiveness of Isosorbide Mononitrate vs Prostaglandin E2 Gel for Cervical Ripening: A Study

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

1. Ganesh R Tathe
2. Mayuri S Dixi
3. Savita A Somalwar
Publishing Year
Author Affiliations
1. com.mps.common.model.Contributor@3955f95 ,
2. com.mps.common.model.Contributor@1b707c27 ,
3. com.mps.common.model.Contributor@460d7095
Article keywords
Cervical ripening, Isosorbide mononitrate, Modified Bishop\'s score, Preinduction cervical ripening, Prostaglandin E2 gel


Background: Till date, search is going on for an ideal agent that can lead to cervical ripening and induction of labor and that is safe for mother and fetus. Isosorbide mononitrate (IMN) is an agent that is also used for preinduction cervical ripening but few studies are done with this drug and hence this study was carried out. Aims and objectives: To study efficacy of IMN and PGE2 gel for preinduction cervical ripening and to study side effects of both drugs. Materials and methods: It was a randomized controlled trial. Participants were selected according to the selection criteria. Group I included 100 participants in whom tab IMN was used. Group II included 100 participants in whom PGE2 gel was used. Outcome measures assessed were age, parity, gestational age, indication for induction of labor, assessment of modified Bishop\'s score (MBS) at 0 and 24 hours, change in MBS, and drug-related side effects. Statistical analysis was done. Results: Mean age, parity, and mean gestational age were comparable in both groups. Postdatism and preeclampsia were indications for induction in both groups. Modified Bishop\'s score at 0 hour was comparable in both groups. Change in the MBS at 24 hours was 2.91 ± 1.34 in group I and 4.52 ± 2.22 in group II. Drug-related side effects were more in group I than in group II. Conclusion: PGE2 gel was more effective for cervical ripening as compared to IMN. Isosorbide mononitrate leads to more side effects.

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