Effect of Vaginal Isosorbide Mononitrate versus Effect of Vaginal Dinoprostone on Cervical Ripening for Induction of Labor

Background: Labor induction has risen significantly over the last twenty years. Induction of labor is indicated for either maternal (preeclampsia, pregnancy-induced hypertension) or fetal (pregnancy induced hypertension, preeclampsia, and postdate pregnancy). Aim of Work: The aim of the study to assess the best method in induction of labor either vaginal Isosorbide Mononitrate or vaginal Dinoprostone. Patients and Methods: A randomized clinical trial was carried out on 44 full-term pregnant women who were admitted for induction of labor in Zagazig University Hospitals in the period of November 2020 to August 2021. Patients were divided into two groups: Group A included 22 full term pregnant females who received 20mg of intravaginal Isosorbide Mononitrate (Effox20mg, Minapharm). Group B included 22 full-term pregnant females who received 3mg of vaginal Dinoprostone (Dinoglandin E2, Rotabiogen) single dose. Results: There was little difference between the effectiveness of 20mg of intravaginal Isosorbide Mononitrate and 3mg of vaginal Dinoprostone in induction of labor. The safety profiles of both drugs were similar, but isosorbide mononitrate administration is considered a low-risk method of labour induction for pregnant women at full term. Conclusions: This study demonstrated that it is safe to use IMN in induction of labor with less side effects than Dinoprostone as cause of failed induction with Dinoprostone was only due to uterine hyperstimulation that lead to sudden and sever fetal distress, while with IMN there were different causes including fetal distress or 2nd ,3rd degree meconium on AROM. Also, with Dinoprostone there was higher incidence of neonatal admission to NICU after birth than IMN that has no incidence of neonatal admission to NICU