Comparison the Effect of Different Doses of Isosorbide Dinitrate Vaginal pre-Induction Cervical Ripening in Term Pregnancy

Backgrounds: Labor induction by prostaglandins is the use of medications or other methods to bring on (induce) labor. Isosorbide D-nitrate can be a good alternative to cervical preparation, but there are disagreements about prescribing doses. The aim of this study is Comparison the effect of different doses of isosorbide dinitrate vaginal pre-induction cervical ripening in term pregnancy.Material and Method: This study is randomized clinical trial was conducted on pregnant women in the maternity ward of Imam Reza Teaching Hospital in kermanshah. The women were randomly assigned into one of 4 groups of 40 mg, 20 mg, 10 mg vials of Isosorbide Dinitrate And the placebo group, the data were entered into the spss-16 statistical software and analyzed.Result: The mean age was 27.27 ± 5.28 years, the gestational age was 39.11 ± 2.45 weeks, weight was 30.9 ± 10.04 kg, height 163.26 ± 23.23 cm, body mass index 26.36 ± 2.33 kg / m2, The mean of Bishop score at the beginning of study was 3.20 ± 1.14 and the Bishop score at first four hours was 6.8 ± 2.89. Age, gestational age, mean BMI, mean of Bishop score at the beginning of study, average time from active phase to delivery and Apgar Scores Were similar between the groups. 106 cases were vaginal delivery (88.3%) and 13 cases cesarean section (10.8%) was observed. A specific complication in women after intervention (95% 79.2%) was not observed. Significantly, the mean Bishop score in second 4 hours was higher in 40 mg group than in other groups (P = 0.004), and the mean duration of induction to active phase of labor in the 40 mg Isosorbide group was lower than other groups (P = 0.009). Conclusion: 40 mg vaginal Isosorbide Dinitrate, in cervical pre-induction cavity preparation, was better than vaginal isosorbide Dinitrate 20 and 10 mg in term Pregnancy