Gynecology & Obstetrics: Isonicotinic acid hydrazide (INH): A new agent for cervical ripening at term- Haghighi Ladan- Iran University of Medical Sciences

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Induction of labor is frequently used when continuation of pregnancy is associated with greater risks for mother and/or fetus than intervention (e.g., diabetes, post-term pregnancy, eclampsiapreeclampsia, IUGR or fetal distress) Favorable cervix is a prerequisite for successful induction of labor. However, in many cases, there is an indication for labor induction in the absence of favorable cervix.At present, misoprostol is the prostaglandin of choice for induction of labor in a number of countries. However, it is associated with serious adverse effects such as uterine hyperstimulation or rupture.Several processes involved in cervical remodeling are similar in mouse and human and studies in murine pregnant cervix have shown that during pregnancy, increase in collagen solubility decreases tissue rigidity and results in cervical softening. Furthermore, it has been reported that isonicotinic acid hydrazine (INH), an antituberculosis agent, increases collagen solubility due to inactivation of lysyl oxidase. This enzyme is responsible for initiating cross-link formation in collagen and it is proposed that INH may cause lysyl oxidase inhibition by competing for its obligatory cofactor, pyridoxal phosphate. Crosslinks between collagen molecules are essential for strength of collagen fibers and tissues and reductionin collagen cross-linking has been shown to decrease mechanical strength of the resulting tissue .