Abstract | OBJECTIVE: DESIGN: A prospective, randomised, double-blind controlled trial. SETTING: Tertiary referral maternity teaching hospital. Population Sixty women with missed abortions and no cervical dilation. METHODS: MAIN OUTCOME MEASURES: RESULTS: The probabilities of induction of cervical ripening by isosorbide dinitrate and misoprostol after four repeated doses at 3-hour intervals were significantly different (P<0.001). Efficacy of therapy after 12 hours was 97% for the isosorbide dinitrate group and 70% for the misoprostol group. Systolic and diastolic blood pressures were lower after administration of isosorbide dinitrate than prostaglandin analogues. The difference in the mean systolic and diastolic blood pressure between treatment groups was greatest at 3 hours, with a difference of 7.7 mmHg (P<0.001) and 5.9 mmHg (P<0.003), respectively. The most frequent side effect associated with isosorbide dinitrate administration was headache, which occurred in 18 out of 30 patients, compared with only 5 out of 30 women in the misoprostol group [relative risk (RR) 2.41, 95% confidence interval (CI) 1.45-4.03, P<0.001). Women treated with misoprostol reported mainly pelvic pain (RR 3.24, 95% CI 1.99-5.27, P<0.001). CONCLUSIONS: Intracervical administration of 80 mg isosorbide dinitrate in women with missed abortions appears to be effective for cervical ripening prior to surgical evacuation of the uterus. Differences in the incidence of non-serious adverse events are not likely to be clinically significant.
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Authors | Gabriel Arteaga-Troncoso, Alejandro Villegas-Alvarado, Aurora Belmont-Gomez, Francisco J Martinez-Herrera, Roberto Villagrana-Zesati, Fernando Guerra-Infante |
Journal | BJOG : an international journal of obstetrics and gynaecology
(BJOG)
Vol. 112
Issue 12
Pg. 1615-9
(Dec 2005)
ISSN: 1470-0328 [Print] England |
PMID | 16305563
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Gels
- Nitric Oxide Donors
- Isosorbide Dinitrate
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Topics |
- Abortion, Induced
(methods)
- Administration, Topical
- Cervical Ripening
(drug effects)
- Double-Blind Method
- Female
- Gels
- Humans
- Isosorbide Dinitrate
(administration & dosage)
- Nitric Oxide Donors
(administration & dosage)
- Placenta, Retained
(surgery)
- Pregnancy
- Pregnancy Trimester, First
- Prospective Studies
- Treatment Outcome
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