الفهرس 
Comparative study between vaginal misoprostol alone and -a the combination of vaginal misoprostol with isosorbide mononitrate in induction of labor in primiparas with premature rupture of membranes and low bishop
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Abstract
Objectives The aim of the study is to compare misoprostol alone and the combination of misoprostol and isosorbidemononitrate for induction of labour in pregnant females with PROM regarding efficacy, safety, maternal and fetal outcomes. Methods A total of 100 women diagnosed with PROM were enrolled prospectively, all of those patients presented during the period of September 2019 till March 2020 to Kasr-Al Ainy Obstetrics emergency department , divided into 2 equal groups: group A who was offered induction of labour by administration of 25 ugs of vaginal misoprostol alone and group B who was offered induction of labour by administration of 25 ugs of vaginal misoprostol and 40 mg of isosorbidemononitrate, in both groups the following was studied: Induction to onset of labour time, induction to delivery time, failure of induction due to maternal or fetal cause, need for augmentation of labour by oxytocin and recording any maternal or fetal morbidity. Results Our results showed highly statistically significant difference between both groups regarding induction to onset of labour time with shorter time in group B, the needed number of doses of misoprostol were significantly higher in group A compared to group B (P- value = 0.001), the need for augmenation by oxytocin was significantly lower in group B (P-value >0.001). On the other hand, there were no statistically significant differences between both groups regarding failure of induction, mode of delivery and the incidence of fetal or maternal morbidity