Nitric oxide donors for cervical ripening in first-trimester surgical abortion

Abstract

NO donors are inferior to prostaglandins for first-trimester cervical ripening, and associated with more side effects. NO donors are comparable to placebo and no treatment for cervical ripening.

Oral Misoprostol and Vaginal Isosorbide Mononitrate for Labor Induction

“…27 Our data show that the addition of vaginal isosorbide mononitrate to oral misoprostol confers no reduction in time to delivery and results in a high incidence of headache, suggesting a similar limited role for isosorbide mononitrate in inpatient cervical ripening and labor induction.…”

Effect of isosorbide mononitrate for cervical ripening before surgical termination of pregnancy in the first trimester

“…During the study period we also performed a meta-analysis, comparing nitric oxide donors for cervical ripening in first-trimester surgical abortion, which demonstrated a comparable effect between nitric oxide donors and placebo in terms of efficacy and patient satisfaction, but caused more nausea and vomiting [21].…”

Can isosorbide mononitrate be useful in second trimester termination of pregnancies?

“…Various mechanical and pharmaceutical methods for cervical ripening have been used over the years [1]. Recently, an increasing interest in the use of nitric oxide (NO) donors in order to facilitate cervical ripening has been reported [2]. Still, no consensus exists upon their impact on shortening this procedure, but published results are encouraging and merit further investigation.…”

“…Therefore, it is thought that substances that can act as ΝΟ donors in the cervix can also cause its ripening. So far, regimens that have been studied include isosorbide mononitrate (IMN) and dinitrate, sodium nitroprusside and glyceryl trinitrate administered vaginally in various dosages [2].…”

“…There is now data about the use of ΝΟ donors in induction of labor [8,9] and also first trimester terminations of pregnancy [2,10]. The published results are contradictory and inconclusive.…”