الفهرس 
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Abstract
Summary
It is now generally accepted that the uterine cervix plays
an important role during pregnancy and labor and that it
depends on an active ripening process within the cervix; which
is necessary for successful labor induction.
Different methods of cervical ripening have been used
including non pharmacological methods as breast stimulation,
membrane stripping and amniotomy, pharmacological methods
including estradiol, oxytocin, prostaglandins and prostaglandin
analogues have been tried.
Previous trials have investigated that possible use of
nitric oxide donor in induction of cervical ripening.
The objective of this study was to compare the
effectiveness and safety of Isosorbide mononitrate plus
misoprostol versus misoprostol alone for pre-induction cervical
ripening in full term pregnancy.
In the present study, 100 pregnant women were included
for induction of labor. They were divided into two groups; each
of fifty women. One group received 40 mg IMN plus 25 μg
misoprostol alone, both were applied in posterior vaginal
fornix, oxytocin was used as hospital protocol for induction of
labor.
Summary
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There was no significant difference regarding the mode
of delivery whether vaginal or cesarean section in both groups.
Regarding the time needed for vaginal delivery between
the two groups, it was found that time in IMN plus misoprostol
group was shorter tan time in misoprostol alone group.
There was no significant difference regarding indication
of cesarean section in both groups.
Regarding the adverse effects of Tachysystole and
hyperstimulation, there were no significant differences between
both groups. While headache was more frequent in IMN plus
misoprostol group. However, this complication was minimal
and self limited and needed no medical interference.
The results suggested that IMN plus misoprostol is more
effective for pre-indication cervical ripening compared to
misoprostol alone.