Evidence map›Paper›PMID 31751343›Full record

Trial reportPloS one2019

A randomized controlled trial comparing isosorbide dinitrate-oxytocin versus misoprostol-oxytocin at management of foetal intrauterine death.

Gabriel Arteaga-Troncoso, Aide E Chacon-Calderon, Francisco J Martinez-Herrera, Sylvia G Cruz-Nuñez, Marcela Lopez-Hurtado, Aurora Belmont-Gomez, Alberto M Guzman-Grenfell, Blanca E Farfan-Labonne, Carlos J Neri-Méndez, Francisco Zea-Prado and 1 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02488642 (Medical Management of Late Intrauterine Death Using a Therapeutic Combination of Isosorbide Dinitrate and Oxytocin.), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02488642 phase4completednot on this map

Medical Management of Late Intrauterine Death Using a Therapeutic Combination of Isosorbide Dinitrate and Oxytocin.

TypeinterventionalSponsorNational Institute of PerinatologyRan2008 to 2014Enrolled60ConditionsCervical Pregnancy, Maternal Care for Late Fetal DeathArmsIsosorbide Dinitrate, Misoprostol, Oxytocin
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Gabriel Arteaga-TroncosoDepartment of Cellular Biology and Development, National Institute of Perinatology, Mexico City, Mexico.ORCID 0000-0001-9419-9572
Aide E Chacon-CalderonDepartment of Obstetrics and Gynecology, Women's Clinic and Neonatology, Secretariat for National Defense, Mexico City, Mexico.
Francisco J Martinez-HerreraDepartment of Obstetrics and Gynecology, Women's Clinic and Neonatology, Secretariat for National Defense, Mexico City, Mexico.
Sylvia G Cruz-NuñezDepartment of Obstetric and Gynecology, National Institute of Perinatology, Mexico City, Mexico.
Marcela Lopez-HurtadoDepartment of Infectology and Immunology, National Institute of Perinatology, Mexico City, Mexico.
Aurora Belmont-GomezDepartment of Clinical Pharmacology, National Institute of Perinatology, Mexico City, Mexico.
Alberto M Guzman-GrenfellDepartment of Immunobiochemistry, National Institute of Perinatology, Mexico City, Mexico.
Blanca E Farfan-LabonneDepartment of Neurosciences, National Institute of Perinatology, Mexico City, Mexico.
Carlos J Neri-MéndezDepartment of Obstetric and Gynecology, National Institute of Perinatology, Mexico City, Mexico.
Francisco Zea-PradoDepartment of Obstetric and Gynecology, National Institute of Perinatology, Mexico City, Mexico.
Fernando M Guerra-InfanteDepartment of Infectology and Immunology, National Institute of Perinatology, Mexico City, Mexico.
Instituto Nacional de Perinatología · MX

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe metabolic activity of endogenous nitric oxide (NO) and the medical use of nitrovasodilatory drugs like isosorbide dinitrate have been shown to be potential inducers inducers of cervical ripening prior to surgical evacuation of the uterus.

objectiveTo assess the therapeutic efficacy and safety of combined isosorbide dinitrate-oxytocin in the management of intrauterine foetal death (IUFD).

methodsSixty women with IUFD after 20 weeks of gestation requesting uterine evacuation were randomly selected to receive isosorbide dinitrate gel solution (80 mg/1.5 mL; n = 30) or misoprostol gel solution (100 mcg/1.5 mL; n = 30) every 3 h with a maximum of four doses or until a Bishop score >7 was reached. Subsequently, patients received a high dose of intravenous oxytocin until complete uterus evacuation was achieved. Therapeutic efficacy was evaluated by mean the relative risk of the foetal expulsion based on comparison of event rates, and the proportion of women induced to labor at 7, 10 and 15 h after the administration of isosorbide dinitrate or misoprostol. Safety was assessed on the basis of woman´s vital signs and evaluation of adverse effects, including headache, abdominal pain, pelvic pain, lower back pain, nausea, dizziness and vomiting.

resultsThe foetal expulsion rate using the isosorbide dinitrate-oxytocin combination was approximately 4.4 times, and at least 2.1 times, the foetal expulsion rate with the misoprostol-oxytocin regimen at any given point in time. The proportion of women achieved vaginal delivery at 15 hours was 100% for the isosorbide dinitrate-oxytocin group and 86.7% for the misoprostol-oxytocin group. The average delivery induction interval was significantly lower when isosorbide dinitrate-oxytocin was used (8.7 ± 3.1 h) than when misoprostol-oxytocin (11.9 ± 3.1 h) was used. A total of 20% of patients in the isosorbide dinitrate-oxytocin group recorded headache, and no cases of uterine tachysystole, haemorrhage or coagulopathy were recorded.

conclusionThis study indicates that intravaginal isosorbide dinitrate followed by intravenous oxytocin was more effective than the conventional method used to induce labour in the medical management of foetal death in pregnancies after 20 weeks of gestation.

trial registrationClinicaltrials.gov NCT02488642.

Indexed as

Fetal DeathAdministration, IntravaginalAdultCervical RipeningDelivery, ObstetricDouble-Blind MethodFemaleHumansInfusions, IntravenousIsosorbide DinitrateLabor, InducedMisoprostolOxytocicsOxytocinPregnancyProspective StudiesIsosorbide DinitrateMisoprostolOxytocicsOxytocin

Identifiers

PMID31751343
PMCPMC6872136
OpenAlexW2989970401

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.