Document Detail

Serum nitrites predict the response to prostaglandin-induced delivery at term.
MedLine Citation:
PMID:  9614643     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate whether the clinical response to prostaglandin-induced labor is modulated by nitric oxide (NO) activity. METHODS: Fifty-two cases of nulliparous women at term who delivered vaginally after prostaglandin E (PGE) induction of labor were enrolled. The induction was required mainly for amniotic fluid reduction or late-onset gestational hypertension. Either intracervical (0.5 mg) or vaginal (2.0 mg) PGE was administered every 12 hours, according to the Bishop score. After the third PGE application, in absence of labor onset, intravenous oxytocin was used. Nitrites/nitrates (NOx) serum levels were used as a marker of NO activity. They were measured just before the start of induction by using an enzymatic reduction and then a colorimetric evaluation. Time to delivery from the first PGE application was the main outcome variable. RESULTS: Time to delivery ranged from 4 to 62 hours (median: 15.5). Nitrites/nitrates levels were unaffected by both gestational age, Bishop score at entry, indication allowing labor-induction, fetal position, and birth weight. In a multiple regression analysis including the previous factors, NOx levels significantly explained 33.9% of the variance of the time to delivery. Indeed, patients delivering within 15 hours (26.4 +/- 6.9) showed NOx levels significantly lower than in patients delivering after more than 15 hours (39.5 +/- 16.4) from the first PGE application. CONCLUSIONS: A reduced level of NOx is associated with a prompt clinical response to PGE-induced labor. Provided we do not know the origin of NOx in the general circulation, these data indicate NOx levels as predictors of the response to PGE-induced delivery at term and support the hypothesis that labor onset is modulated by the endogenous NO activity.
F Facchinetti; A Gandolfi; M Longo; A Volpe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Society for Gynecologic Investigation     Volume:  5     ISSN:  1071-5576     ISO Abbreviation:  J. Soc. Gynecol. Investig.     Publication Date:    1998 May-Jun
Date Detail:
Created Date:  1998-08-24     Completed Date:  1998-08-24     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9433806     Medline TA:  J Soc Gynecol Investig     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  140-3     Citation Subset:  IM    
Department of Obstetrics, Gynecology, and Pediatric Sciences, University of Modena, Italy.
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MeSH Terms
Biological Markers / blood
Cohort Studies
Delivery, Obstetric*
Gestational Age
Infant, Newborn
Labor, Induced*
Nitrates / blood*
Nitric Oxide Synthase / metabolism
Nitrites / blood*
Regression Analysis
Time Factors
Uterine Contraction
Reg. No./Substance:
0/Biological Markers; 0/Nitrates; 0/Nitrites; 0/Oxytocics; 363-24-6/Dinoprostone; EC Oxide Synthase

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