Comparative Study between Combined Vaginal Misoprostol with Isosorbid -5- Mononitrate versus Misoprostol alone for Induction of Second Trimesteric Abortion

Authors

1 Professor of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 MBBCH of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: For medical reasons, prostaglandins or their analogs are frequently given during second-trimester abortions to relax the uterine cervix. Aim of the work: Is to comparing the efficacy of misoprostol alone with misoprostol combined with isosorbid-5-mononitrate in the second trimester of pregnancy. Patients and Methods: Following their agreement, a total of one hundred pregnant women were enrolled and split into two equal groups. Group A was given 400 µg of misoprostol and 40 mg of isosorbide nitrate intravaginally in the posterior vaginal fornix. 400 micrograms of misoprostol and 40 milligrams of isosorbide mononitrate were administered repeatedly every four hours until the fetus was ejected. Every four hours, Group B was given 400 µg of misoprostol tablet intravaginal in the posterior vaginal fornix until the fetus was evacuated. Results: Duration till abortion was shorter in isosorbide mononitrate+misoprostol group. Number of cases who had complete abortion was statistically significant higher in isosorbide mononitrate+misoprostol group. Conclusion: Due to the fact that isosorbide-5-mononitrate increases the effectiveness of misoprostol, shortens the induction abortion interval, and reduces the risk of an incomplete abortion, it is recommended to take the two drugs together to induce second trimester termination of pregnancy.