Trial of Cervical Ripening and Labor Induction Using Misoprostol With or Without Intravaginal Isosorbide Mononitrate

Randomized Clinical Trial of Cervical Ripening and Labor Induction Using Stepwise Oral Misoprostol With or Without Intravaginal Isosorbide Mononitrate

The purpose of this study is to determine the efficacy and safety of the addition of intravaginal isosorbide mononitrate to an established protocol of oral misoprostol for cervical ripening and labor induction.

Inclusion Criteria::

• Pregnant women
• 18 years of age or greater
• Singleton pregnancy between 32-42 weeks gestation requiring labor induction
• Membranes must be intact

Exclusion Criteria:

• Ruptured membranes
• Gestational age less than 32 weeks
• Non-reassuring fetal heart rate tracing