الفهرس 
Physiological background of the onset of Normal
Ethical ConsiderationsOnly 14 pages are availabe for public view
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Abstract
In modern Obstetrics, induction of labor with different methods still represent itself as an interesting topic and the reason for that is that it approaches and affects nearly every corner in the Obstetrical world. However, the most important thing to this research, is that induction and augmentation of labor positive results antagonise cesarean delivery rates; therefore, if we improve the induction of labor experience in all aspects, we will decrease the cesarean delivery rates and that will subsequently decrease its complications. Nowadays, the aggressive increase in cesarean delivery worldwide is no longer only worrying but disasterous considering the proportionaly increasing short-term and long-term complications.
Nitric oxide donors are pharmacologically active substances that release nitric oxide in vivo or vitro. Nitric oxide itself has a variety of functions such as the release of prostanoids specially prostaglandins, help with the process of angiogenesis, inhibit platelet aggregation, increase production of oxygen free radicals. Our main interest is the release of prostaglandins function which may affect the uterine activity and the cervical favorability.
In this research, the point of interest and aim was to study the safety and efficacy of Nitric oxide donors which have been suggested as safe and effective agent to decrease induction to delivery time and/or improve cervical ripening and favorability. There have been a number of studies suggesting different results and conclusions.
Fifty primigravidae were recruited in this study, they were divided into two groups, each group consists of 25 women. One group took Isosoride mononitrate and Misoprostol (IM &M), the other group took only Misoprostol (M only) to start the induction process. The results were promising.
There was a statistical difference between Isosorbide mononitrate & Misoprostol group versus Misoprostol only group regarding induction to delivery time ( mean 20.18±3.64 to 23.94±4.03 hours respectively) p-value was <0.001, induction to active phase interval (mean 11.39±5.22 to 15.53±6.18hours respectively) p-value was 0.014, neonatal birth weight (mean 3.46 ± 0.31 to 3.24 ± 0.18 kilograms respectively) P-value = 0.003, maternal headache (36% to 12% respectively) P-value =0.047.
When used with misoprostol, Isosorbide mononitrate appears to be safe agent when used in combination with misoprostol for induction of labor, it does not appear to increase any adverse effects except those known about misoprostol with exception of maternal headache which was increased in the isosorbide mononitrate plus misoprostol group.
Isosorbide mononitrate can be used with misoprostol to decrease induction to delivery interval. It is very early to establish a strong medical opinion about liberal use of isosorbide mononitrate, so it should be used in the research context settings for the time being with the usual precautions taken during the process of induction.