Objective: To compare the efficacy and safety of isosorbide mononitrate (IMN) versus misoprostol used to induce labour for overdue pregnancy.
Setting: A prospective randomized clinical study conducted at AL-Elwiya Maternity Teaching Hospital in Baghdad from Jan. 2008 to Dec. 2008.
Method: One hundred and fifty women with over due pregnancy (past date and posterm pregnancy) referred for induction of labour with Bishop scores <_ 5 were randomly allocated to receive either forty mg isosorbide mononitrate (IMN) tablet as a single vaginal dose (n=75) or fifty mcg misoprostol vaginally (n=75) every six hrs for a maximum of three doses. Amniotomy and/or oxytocin infusion is considered when Bishop scores frankly progressed (augmentation) or used when no improvement achieved after 24 hour (induction). Adverse effects of medications, induction - delivery interval, mode of delivery and neonatal outcome were recorded and subjected to statistical analysis.
Results: Isosorbide mononitrate was associated with less adverse effects than misoprostol especially regarding uterine tachysystol (0 with isosorbide mononitrate vs 12% with misoprostol, P<0.01) and hyperstimulation (0 with isosorbide mononitrate vs 16% with misoprostol, p<0.01) but the induction - delivery interval with isosorbide mononitrate group was significantly longer compared with misoprostol (26.3±7.3hrs vs 15.4±5.4 hrs , p<0.01). Oxytocin was added to 70 women (93.3%) used isosorbide mononitrate while to 15 women (20%) used misoprostol (p<0.001). Caesarean rate was not significantly different between the two groups, but the indications were different, dystocia is the major cause (73.3%) with isosorbide mononitrate while persistent non-assuring fetal heart rate pattern (64%) in the misoprostol group.
Conclusion: Cervical ripening and induction of labour using isosorbide mononitrate resulted in fewer adverse effects but it was less effective than misoprostol.
Isosorbide Mononitrate versus Misoprostol for Cervical Ripening
Misoprostol
cervical ripening
induction
Publication Date
Mon Apr 06 2020
Journal Name
August
INFLUENCE OF SOME FACTOR ON SOMATIC EMBRYOS INDUCTION
AND GERMINATION OF DATE PALM CV BARHI BY USING CELL
SUSPENSION CULTURE TECHNIQUE
This study was done to examine different concentrations of mercuric chloride (Hgcl2) for Explants sterilization and different
concentration of NAA) mg/L with 2iP for their effect on initiation primary callus and subsequent embryogenesis in Phoenix
dactyliferae cultivar Barhi. Leaf primordial and shoot tips were excised from 2-3 years old offshoot. The result showed that
contamination percentage decreased with an increase in concentration of Hgcl2 for two explants where in the control (0.0)%
gave highest value 75% and 62.5% of contamination for leaf primordial and shoot tip respectively while the addition (0.1)%
gave a significant decrease 37.5 and 0% for explants respectively. The Explants were inoculated onto Murashiege and Skoog
1962 (MS) medium supplemented with 2iP 3mg/L and containing 0
25
50 or 100 mg/L of NAA
the addition (50) mg/L of NAA
gave highest value 68.8% in percentage of callus initiation with significant difference from addition 0% gave lowest value
(18.8)%
as well Explants of shoot tip gave significant difference was 53.1% while leaf primordial gave 28.1%
Primary callus
was transferred to fresh MS medium containing (0
5
10 and 20) mg/L of NAA with 3mg/L 2iP
Results were recorded after 12
weeks. A highest value of embryonic callus induction percentage or fresh weight and dry weight 87.5% or 1.56g and 0.47g for
the character respectively for the treat 20 mg/L while control treatment 0.0 gave the lowest value 12.5% or 0.37g and 0.14g for
same character respectively. Inoculated 1g fresh biomass into a 250 ml Erlenmeyer flask containing 50 ml MS liquid medium
supplemented with NAA 20mg/L and agitated at 150 rpm by shaker to making suspension culture the measurements of
packed cell volume ( pcv) or fresh and dry weight taken weekly for 12 weeks
maximum values were reached in the eighth week
of PCV and fresh weight but the dry weight reached to highest value in seventh week
then the curve began to decline
gradually until it reached stability in the last two weeks. The cell suspension was Diluted to different initial cell density of 100
500
10000
50000 and 100000 cells /ml with hemocytometer. The initial cell number of (10000) cells gave significant different
of plating efficiency PE (11.6)% while (100) cells gave lowest value 1.8% of PE.