Ripening of the Cervix With Sodium Nitroprusside in Nonpregnant Women


OBJECTIVE: Few clinical trials have examined the effects of nitric oxide donors on the human cervix. We address the question of the ultrastructural and clinical effects of topical NO donor on the nonpregnant human cervix. METHODS: Twenty patients admitted to the hospitalfor hysterectomy were randomly assigned to receive either placebo gel or 10 % nitroprusside-based gel into the cervical canal. After surgery, a small biopsy of the cervical canal was taken and analyzed by electron microscopy. Vital parameters were monitored after application. RESULTS: In the placebo group, the connective tissue was normal. In the experimental group, the collagen fibers were widely spaced, and no longitudinal collagen bundles were visible. Macrophages, leukocytes, and activatedfibroblasts in treated tissues demonstrated a proinflammatory reaction. Adverse effects were reported in a minority ofsubjects. No significant changes in blood pressure or in nitrite and nitrate levels were reported. CONCLUSION: In both fertile and postmenopausal women, cervical sodium nitroprusside induced morphologic changes similar to those reported for the ripening process. (J Soc Gynecol Investig 2003; 10: 438- 42) Copyright (C 2003 by the Society for Gynecologic Investigation. KEY WORDS: Cervix, nitric oxide, electron microscopy, sodium nitroprusside, menopause

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