Purpose: Comparison of vaginal Isosorbaid mononitrat and vaginal estradiol and placebo effect on cervix ripening in post term pregnancy
Design study: a randomized, triple blind, placebo-controlled
The methods used included:
(A):
Key inclusion criteria: singleton pregnancy; cephalic presentation; intact membranes; BS less than 6; the result of normal fetal health monitoring; lack of uterine contractions; the absence of systemic problems; age 15 - 35
Main exclusion criteria: women with preeclampsia; history of previous cesarean; active genital herpes; poly Hydramnious; placenta previa or placental abruption risk; membrane rupture; history of Cardiac or respiratory disease; the presence of any contra indication for labor induction; systolic blood pressure less than 90 mmHg
Sample size: 99
(B) Interventions in the study:
From all of mothers, we will obtain a NST, and then patients will be divided into three groups according to randomized block plan. At the first group, vaginal estradiol 25 micro gram, at the second group, vaginal isosorbide mononitrate 20 mg, and at the third group, placebo placed in the posterior fornix and 12 hours after hospitalized, If BS is less than 6, previous dose is repeated again. Cervical examination is done every 2 hours.
(C) The intervention time: At arrival, and 12 hours later.
(D) The primary outcome or consequences of the study: to improve the cervical Bishop score, better response to induction of labor, cesarean section rate reduction